The COVID-19 lockdown sought to protect the health-care system and the most vulnerable. Health authorities quite early identified that the elderly and those with chronic conditions were most vulnerable.
Various leaders reminded us that among those most at risk were members of the Greatest Generation, the Canadian men and women who defeated the Nazi scourge. They sacrificed much to keep us from tyranny, and this was our turn to protect them, we were told.
The virus is far from extinguished and there could still be waves so final assessments of the COVID-19 lockdown will have to wait. But now that the infection has partially slowed and restrictions are beginning to loosen, let’s acknowledge with honesty that we failed the most vulnerable so we can begin to find effective solutions.
Quebec officials won’t stop boasting that they have a lower fatality rate than some Western countries, as if comparing with Belgium (which has the worst death record among Western countries) is better than comparing Quebec with Ontario or B.C. Political spin seeking to distract from the disaster in care centres for the elderly will solve nothing. The disaster has been roughly spread out in Canada but is most prevalent in Central Canada.
The numbers show how dreadful things are. About four out of five Canadian COVID-19 victims (double that of the United States) lived in a long-term facility. Of the five million Canadians over age 65, about 400,000 live in long-term facilities.
Current Canadian figures show a national death rate of less than 0.02 per cent. But it increases to roughly 1.5 per cent when looking at deaths among seniors. And when we isolate the number of seniors living in care centres, the death rate jumps to 17.5 per cent (almost the general death rate in Belgium). In some centres, every resident was infected and about one in five were fatally infected.
A death rate for the vulnerable that’s 875 times greater than that of the general population is appalling. The terrible conditions plaguing some centres are only indirectly connected to the failure to protect the vulnerable. But it’s the industrial warehousing model itself that must be questioned.
The atrocious infection and death rates demonstrate the high risk among concentrated populations. But the risk precedes and doesn’t originate with the mismanagement and abuses now documented in the Canadian Forces reports for Ontario and Quebec care homes. To find appropriate solutions, the question of abuses needs to be separated from the inherent risk in centralization and concentration.
We need more than platitudes to solve this complex issue.
Prime Minister Justin Trudeau’s proposed solution is to throw money at the problem and there is talk of imposing federal standards.
The provinces must resist Ottawa’s desire yet again to encroach on provincial jurisdiction. Undoubtedly, people in these facilities need better pay and better work conditions, but we would deceive ourselves in accepting federal money as a solution.
However, the heart of it is that some elderly people choose and some have no other option but to live in human warehouses.
The options to place care facilities under federal regulation, installing better protocols, better ventilation, with more and better paid staff will not fully mitigate the massive risk of warehousing people in large numbers. As long as these care factories exist, disaster will follow when infectious pathogens enter them.
Nor will tighter constraints inside such centres to prevent high death rates during pandemics improve the quality of life for residents. To the contrary, they will erode it.
And whatever the potential solutions, governments shouldn’t take over. That would create greater problems because bureaucracy is the poorest guardian of human dignity. Besides, the public is now wiser and many would rather succumb to a virus than be subjected to isolating oppression, robbed of all indignity during one’s last days.
That leaves us with a crucial opportunity to phase out the warehousing as the demand for long-term care spaces triples over the next couple of decades. Would-be users should demand better alternatives and push the market to offer better and more varied choices.
Public policy can provide incentives (not subsidies) for small-scale alternatives, away from industrial models. Sweden and Denmark offer viable and adaptable examples, variants of which were piloted in Alberta in the mid-1990s.
In the shortest term, there needs to be safer solutions in the event of a COVID-19 second wave. But long term, a variety of small-scale alternatives that uphold the dignity of residents as a high priority is the best way to atone for the current failures.
Marco Navarro-Génie is president of the Haultain Research Institute and senior fellow at the Frontier Centre for Public Policy.