“Every Store and School Should be Open.” Confronting the Pandemic with Confidence
A uniquely Albertan perspective, reposted from C2C Journal, authored by Peter Shawn Taylor, December 7, 2020
Before Covid-19, there was 9-11. And the morning after the world changed on September 11, 2001, David Redman, Director of Community Programs for Emergency Management Alberta, found himself in Edmonton with 26 other experts representing key government and private sector interests grappling with how the province should respond to this new terrorist threat.
“We spent the first two hours brainstorming, everyone just threw all their ideas on the table,” Redman recalls today. “As a result, we had a million ideas sitting there and no one had a clue what to do with them.” When the other attendees took a much-needed coffee break, Redman got busy with the white board – diagramming, charting and arranging the disparate thoughts into a matrix of five organizational groupings and ten crucial activities. “That’s how you write a plan,” he says, speaking from experience. Soon he was head of the province’s counter-terrorism strategy, a plan that won accolades across the continent for its thoroughness. Paul Cellucci, then U.S. ambassador to Canada, was so impressed after touring Alberta’s emergency command centre that he invited Redman to Washington to brief Senate and House committees on what he’d done. Redman retired as executive director of the Alberta Emergency Management Agency in 2005.
Lieutenant-Colonel David Redman during the Change of Command ceremony in Lahr, Germany in 1992 and on Remembrance Day, 1995 in the former Republic of Yugoslavia.
That was his second retirement. Redman had previously served 27 years in the Canadian Armed Forces, rising to Lieutenant-Colonel. In the early 1990s he was in charge of closing Canada’s army base in Lahr, Germany. The complicated two-year mission to bring home 18,000 Canadian troops, their equipment and families and wind up what was essentially a small city was the largest military logistics operation this country had executed since the Korean War. Under Redman it was completed a month ahead of schedule. “We wrote a brick of a plan from scratch – it was several inches thick – and we followed it,” he recalls. A couple of years later, he was deployed to Croatia and Bosnia where he was tasked with the withdrawal of Canada’s United Nations contingent from the former Republic of Yugoslavia, and then the later insertion of a Canadian army Battle Group during NATO operations, all in the middle of a war zone.
Every emergency may be different, but the planning and preparedness process should always be the same: The 2001 attack on the World Trade Center towers, Fort McMurray’s devastating wildfire of 2016 and the 1998 ice storm in Quebec (left to right).
When he left the Alberta Emergency Management Agency in 2005, he embarked on a third career as an organizational consultant – writing plans, giving keynote addresses and advising agencies, including the federal Auditor-General’s office, on best practices for emergency planning. Redman, now 66, retired for good in 2013.
At the risk of stating the obvious, Redman knows how to plan for an emergency, and how to put plans into action. His accumulated military and civil expertise – as well as two science degrees – is not merely interesting and impressive, it is extremely well-suited to evaluating and critiquing Canada’s current response to Covid-19.
Unfortunately, no one in charge seems interested in hearing Redman’s advice. A series of detailed plans he offered to Alberta Premier Jason Kenney, and later to all the other premiers through the Council of the Federation, have either been completely ignored or passed off as old news. Rather than let a lifetime’s experience go to waste, C2C Journal’s Peter Shawn Taylor sat down with Redman last week to learn the basic rules of emergency planning, the many catastrophic mistakes our governments have made to date and how to shift the focus of Canada’s Covid-19 response from fear to confidence before it’s too late.
C2C Journal: Throughout this crisis we’ve heard plenty from public health officials and doctors, and to a lesser-degree from economists and assorted other public policy experts. But while it’s popular to talk about how we are “at war” with Covid-19, we’ve heard next to nothing from the people who actually know how to win wars. Take us through the military perspective on how we should be battling this disease.
David Redman: The first step to resolving emergencies is to respect the planning process. From the time I was a lieutenant, the army taught me to begin with what we called the Estimate of Situation. Once you have your problem, you analyze the mission: Who is your enemy? Who are your allies? What tasks are given? What tasks are implied? What can go wrong? After many years working with government and the private sector, I’ve discovered that the knowledge and skills required for this sort of operational planning are severely lacking outside the military.
When an emergency happens, you need a process to create a plan, and then you need to follow that plan. Since the 1950s every government in this country has had a set of emergency plans: what to do in the case of a forest fire, flood, dangerous goods accident or pandemic etc. These are all updated regularly. Alberta’s pandemic plan was last updated in 2014.
But what happened in the middle of March when Covid-19 appeared on our shores after wreaking havoc in China, Italy, Spain and France? Governments took every plan they’d ever written and threw them all out the window. No one followed the process. They panicked, put the doctors in change and hid for three months. And now, having made that mistake, we can’t get out of it.
C2C: Why is it a mistake to put doctors in charge of a pandemic?
DR: The short answer is that a pandemic is not a public health emergency. It is a public emergency. These are two very different things. Public health emergencies are best used for local outbreaks of disease. An outbreak of measles in a single community that can be isolated could be considered a public health emergency. A provincewide or nationwide pandemic should never be declared a public health emergency because the powers that you need and the people who are going to be affected go far beyond the health care system. It affects every citizen, every industry, every non-profit organization. Everything.
he wrong aim: Excessive focus on case counts, rather than the broader impacts of the disease, has led Canada’s Covid-19 response astray.
The problem with our Covid-19 response is that power has been placed in the wrong place. Why? Because governments adopted the wrong mission statement. The first principle of war is the selection and maintenance of the aim. If you miss on that, things are going to go very poorly. Across the country it appears to me that our aim has been to minimize the number of people who catch Covid-19. That is repeatedly reflected in the media. The daily case count is the most important thing in every daily newscast and every news story. It’s all the politicians seem to talk about. This is wrong.
C2C: If minimizing the case count is the wrong mission statement, then what should our mission statement really be?
DR: Our aim must be to minimize the impact of Covid-19 on the province as a whole. Not the case count. Not even the death count. Here are the four goals taken directly from Alberta’s 2014 pandemic plan:
- Control the spread of disease and reduce illness and death by providing access to appropriate prevention measures, care and treatment.
- Mitigate social disruption by ensuring continuity and recovery of critical services.
- Minimize adverse economic impacts.
- Support an efficient and effective recovery.
Note that one of the objectives is to minimize illness and death of the newly emerging disease or threat. But that’s just one of four objectives. Equally important is to ensure that we do not neglect – intentionally or unintentionally – any other pre-existing diseases or conditions. The overall aim of the plan is to minimize both the impact of the new disease, and the effects arising from the response to it, on the entire jurisdiction. And then to get back to normal as quickly as possible.
C2C: Perhaps Covid-19 is categorically different from other emergencies, given its global scope?
DR: The enemy may be different, but the process is always the same. All plans are written in the same format even if they address different enemies. An Ebola epidemic, for example, requires a completely different plan from Covid-19. The transmission rate is different, the mortality rate is different and so on. That means you react differently.
Once you have developed a pandemic plan, modified to the specifics of the disease, it is very important that it be written down and released. Such a plan should have been handed to every reporter in the country. No jurisdiction has done that. It appears that every jurisdiction, like Alberta, that had a pre-existing pandemic plan simply ignored it and created a new plan on the fly. But if you don’t put a plan in front of the public, they will have no confidence things are going to get better. And confidence in government is one of the primary objectives when a state of emergency is declared.
‘Medical officers of health should never be in charge in any pandemic’: Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo, Chief Public Health Officer Dr. Theresa Tam and federal Minister of Health Patty Hajdu (left to right). (Image credit: Justin Tang/CP)
The fact remains: medical officers of health should never be in charge in any pandemic. This goes right back to the operational planning process. The health care system is the subject matter agency. It deals with operating the hospital system, ensuring health care providers are appropriately trained, ensuring the public is given proper information about the disease and, ultimately, distributing a vaccine. If we were facing a forest fire, Wildfire Operations would be the subject matter agency. It would fight the fire. But it would not be in charge of the entire government response.
Everything else must be handled by a cabinet committee or an emergency management organization that can take into account the impact of the pandemic on the rest of society. Why would anyone put a medical officer of health in charge of an entire province? What do they know about a meat packing plant? Or the water supply system? Or a power grid? Nothing. Their advice is critical – but it should deal exclusively with medical issues. They do not know how to run a province.
In March, April and May, however, we saw provincial leaders hand their chief medical officers the keys to their jurisdictions. The result was lockdowns across the country, of varying intensity. Now, the news media believe public health should be in charge all the time. And that a lockdown is always the best solution.
C2C: The notion that public health officials should be fully in charge during a pandemic is quite pervasive. Recently the Auditor-General of Ontario issued a scathing report on that province’s Covid-19 response. Her first complaint was that “Ontario’s command structure…was not dominated by public health expertise. The Chief Medical Officer of Health and other public health officials did not lead Ontario’s response to Covid-19.” What do you make of this?
DR: I think Ontario’s Auditor-General is very poorly informed.
C2C: Rather than put doctors in charge, what should we have done in response to Covid-19 in those first crucial months last spring?
DR: Since the middle of March, we had access to reliable statistics from China, Spain, Italy, France that showed quite clearly 70 percent of all deaths arising from Covid-19 were of people over the age of 80. Another 18 percent were 70 to 79 years old. Only three-and-a-half percent were under the age of 60. And less than 1 percent of the people who’d died up to that point didn’t have at least one pre-existing underlying medical complication. This wasn’t September. This was March. We knew very quickly what Covid-19 was doing – it was killing old people who had severe comorbidities. The immediate response should have been: how do we protect those people?
As we say in the military, an 80 percent solution applied with vigour immediately is better than a 100 percent solution applied too late. What holds in a battle holds in pandemics too. First, we should have identified every concentration of vulnerable people, including all nursing homes, hospitals and palliative care homes. Then comprehensive options should have been developed to quarantine both the residents of these facilities and the staff who supported them. Support and relief systems for these staff and surge capacity should have been discussed back in March. Instead each new outbreak in a seniors home seemed to come as a surprise.
If Quebec had made the hard decision to quarantine all its seniors’ homes and staff in early March, it might have cost $1 billion and caused an uproar. But the province would have experienced a mere fraction of the deaths that have since occurred. To do this, however, you would need to declare a public emergency. Not a public health emergency. Because now you are impacting the lives of all citizens.
C2C: If we only need to quarantine seniors and their support workers, what happens to the rest of society?
DR: We also knew very quickly that as Covid-19 spreads into the community, other people will get sick. In almost all cases they’re not going to die. Will they get sick enough that they can’t go to work? Yes. Could enough people get sick that it could affect our critical infrastructure? We don’t know. So, the next phase of the plan should have been to look at the people necessary to keeping the water, power and food systems running and quarantine them as necessary. Instead we saw vital components of our supply chain surprised by illnesses and shut for extended periods.
Quarantines are a powerful tool. But they need to be used appropriately. It is outrageous to hear doctors say we need to lock down healthy people for no reason. Our medical and education systems are overwhelmed, both emotionally and physically, because workers are being sent home for 14 days when they’re perfectly healthy. One person with Covid-19 walks into a hospital and we send 20 staff home. Now everyone else has to work overtime or double shifts. My granddaughter is 16. She’s been sent home twice from school for two weeks at a time because someone in her cohort group of 80 kids tested positive. She never got sick.
Inside the hot zone: Immediately quarantining Canada’s most vulnerable people, including seniors in nursing homes and hospitals along with their necessary support staff, was the only way to protect them from Covid-19 back in March.
We are sending healthy people home because we are terrified of the case count going up. It is not a crime for people to catch Covid-19, but we are acting like it is. And given what we now understand about asymptomatic patients, half of the population could catch Covid-19 and never know it. Those who do get sick don’t die unless they have comorbidities and are over the age of 60, with very few exceptions. We are destroying our medical system and needlessly disrupting our school system while stressing millions of parents, teachers and pupils in chasing case counts.
C2C: I can see the strict utilitarian benefit to locking up a few to save the many, but basically imprisoning hundreds, perhaps thousands, of long-term care workers for months on end to protect our seniors, or doing the same to power plant staff, seems like a tough call. Especially if you are not locking down the rest of society.
DR: I would do it the same way you fill the worst jobs in the army. You ask for volunteers. In the middle of some very dangerous situations in Yugoslavia, I would look at my men and say, I need 26 drivers and 26 shotgun riders. I’m riding shotgun, who’s going with me? I needed 51 other people, and I always had too many.
I am prepared to deny some people their civil liberties, but I bet it wouldn’t be very many because you’d be able to fill most jobs with volunteers, especially if they see they’re part of a published plan to get the job done. Of course, to make such a decision, you’d need support from an ethics committee that must be embedded in any comprehensive emergency plan.
If it turns out these requirements last for many months, you could set up a rotating shift system. One crew works for all of May, another for June and a third for July. Two weeks before the start of each month, one crew would be isolated in a government-run hotel. Each crew lives “Covid-19-free” for the duration of their pre-isolation and then their month-long shift. Other options could present themselves if you ran a proper Estimate of Situation process at the beginning of the crisis.
C2C: How does our current experience with Covid-19 remind you of 9-11?
DR: My aim with Alberta’s counter-terrorism plan was to protect the province while minimizing restrictions on civil liberties. To do that you have to build confidence in government so people aren’t living in fear. The public has to be certain its government knows how to deal with the situation. Look at the Israelis. They are masters at building confidence when it comes to the fight against terrorism. They understand it may only be possible to catch seven out of ten terrorists before they strike. But the public knows that those other three will be dealt with eventually, and severely. That builds confidence. In this way the public becomes a partner in the fight against terrorism.
‘Confidence has been destroyed’: After seeing the massive death toll in nursing homes, Canadians have lost faith that their governments know how to win the fight against Covid-19. (Image credit: Blair Gable/Reuters)
Confidence in government during the current pandemic has been destroyed. When people willingly accept lockdowns, or in some cases appear to be begging to be locked down again, that shows a complete lack of confidence in government. The public has seen the unmitigated failure of government planning with all the deaths in seniors’ centres. They’re being told daily that their hospitals are overwhelmed. And the public has never seen a written provincial or federal pandemic plan. As a result, they believe anyone who catches the disease is going to die. The media is telling them they should be hiding in their houses and locking the doors. When you hear all this, you lose faith in your medical system and government.
C2C: As new lockdowns loom across the country, some provinces are trying to modulate their response to avoid the severe economic hardships of earlier responses. But this can lead to some unusual outcomes. In Manitoba, for example, stores deemed essential can stay open, but they can’t sell non-essential items. A Costco in Winnipeg was recently fined $5,000 for violating this rule. Does this make sense?
DR: Let me be clear: I don’t believe we should ever have locked down anything. Every store and school should be open. If you are not afraid of catching Covid-19 because your medical system is robust and we have protected our seniors and the death count is low, then the pandemic is essentially over. Instead we have governments in some provinces telling people they can’t buy big-screen TVs, even though they’ve already mandated that watching TV is about your only legal form of entertainment.
Look at Sweden. It has just over 10 million people and has had a little over 7,000 deaths. [Editor’s note: 7,067 as of December 6.] Quebec has a population of 8.5 million and about 7,250 deaths. Sweden has not locked down its economy or shut its schools below the high school level. It does not require masks. It has allowed its population to go out and live their lives, with social distancing requirements of just 1 metre and hand washing measures.
A Swedish success story: Despite relentless criticism from abroad, Sweden deliberately avoided a lockdown; it’s death toll per capita is now substantially below other European countries that instituted full lockdowns.
Who did the better job? The media has tried to vilify Sweden, but it now ranks 24th in deaths per capita, better than many of its European neighbours such as Belgium, Britain, Italy, Spain, and France, all of which have implemented severe lockdowns and imposed strict mask mandates. People could draw their own conclusions if they were given the full facts.
C2C: How would you rate the various responses across the country at both the federal and provincial level? The same folks who want to see public health officials take charge also seem to be demanding Prime Minister Justin Trudeau invoke the Emergencies Act and place the federal government at the apex of the national response. In contrast, Alberta Premier Jason Kenney has made a catch-phrase out of “protecting lives and livelihoods” and resisted imposing comprehensive lockdowns due to their negative effects.
DR: Anyone who thinks Trudeau should enact the Emergencies Act doesn’t understand how our country works. We saw the same thing with counter-terrorism. Almost all the critical infrastructure in this country is provincially based and/or regulated. And that means the provinces must lead the response.
Protecting lives and livelihoods: Alberta Premier Jason Kenney has repeatedly emphasized the broader costs imposed by comprehensive lockdowns.
I think Kenney has said most of the right things. The only way to break the message of fear is to continuously remind the public of the bigger problems lockdowns can cause, and that their government is prepared for the worst. But he needs to be more visible. All the premiers ought to be telling the public every day that they’re not going to lock down, and why. Instead we keep hearing that every death from Covid-19 is a tragedy and that a single life is more important than the economy.
The long-term impact of our response will be felt for years in societal breakdown, mental health problems and the increasing prevalence of other diseases. We are seeing more people dying of cancer and heart disease. People are so afraid of catching Covid-19 that they’re choosing to not go to the emergency room or to see their doctor. The overdose rate is up dramatically in British Columbia since the start of Covid-19. Suicides have increased. Fear is a terrible mental health amplifier.
C2C: Your submissions to the premiers throughout the summer were notable for their insistence that a second wave was coming and that it would be worse than the first. Given we’re now in the midst of that second wave, what should our response be now?
Building in surge protection for hospitals is crucial to restoring public confidence and ensuring other diseases, such as cancer and heart disease, do not become more prevalent.
DR: We need to do what we should have done in March. Protect our most vulnerable – seniors and anyone else who has severe comorbidities. Then we need to protect our critical infrastructure including hospitals. Have we built and segregated an appropriate number of ICUs and hospital beds to handle any surge? When I was in charge of counter-terrorism in Alberta, we had surge capacity listed for every piece of critical infrastructure in the province. We went industry-by-industry and found the people we needed to keep the province running on a back-up basis; many of these people were recently retired. It is only very recently that some provinces have gotten around to doing this for the healthcare system under Covid-19. I screamed when I heard that. It’s total incompetence.
We also need to train the public about what Covid-19 really means. It is almost always not fatal unless you are old and have a comorbidity. World-wide, 96 percent of Covid-19 deaths are those over 65 years old with multiple comorbidities. The main message to the public should be to get out and on with their lives. But to do this, they need to have confidence the system won’t fail them.
Think about our youth: Redman, former executive director of the Alberta Emergency Management Agency, worries about the long-term effects our response to Covid-19 could have on the social development of today’s younger generation. (Pictured: As key note speaker at the Conference Board of Canada’s Emergency Management and Critical Infrastructure Conference in 2008.)
The wide-reaching collateral impacts from our failed response to Covid-19 need to be understood as well. We’ve stopped caring about other health factors such as cancer, heart disease and dementia. This is a big problem.
Then there is the impact on our youth. Think about all those young children and teenagers we have locked in their rooms. What have we done to the social development of a complete generation of children? What has been the impact on their education? How will they react to future emergencies when they are old enough to be in charge?
Finally, we need to figure out how the hell we’re going to pay for all this. We’ve blown hundreds of billions of dollars out the door and now we need a plan to pay it all back and restart industry. And that plan needs to be written down and published so people can hold their governments accountable.
C2C: Whatever the situation, you need a plan. Thanks for your time and expertise.
Peter Shawn Taylor is Senior Features Editor of C2C Journal.
Original Source: https://c2cjournal.ca/2020/12/every-store-and-school-should-be-open-confronting-the-pandemic-with-confidence/