We don’t have to be like Italy

Dr. David Fisman, a professor of epidemiology at the University of Toronto, has done modeling on COVID-19 in Canada, estimating that somewhere between 30 and 70 per cent of Canadians will be infected. Earlier this week he spoke with CBC about the importance of following in the footsteps of places like Hong Kong, and not Italy and France, to fight COVID-19.

“We need to understand the magnitude of the threat we face,” Dr. Fisman said. “We should all be afraid, but we should not let that fear immobilize us. There are simple straightforward things that we can do as a country to fight COVID-19 to go the route of Hong Kong, Singapore and Taiwan on this, and not go the route of Italy and France. Where we need to be going in Canada is preventing those explosive epidemics from happening in the first place. We can do that, and the countries that can show us the way on this are Singapore, Hong Kong and Taiwan. Those are countries that we are not talking about because they are quiet. They are not quiet because they are lucky, they are quiet because of aggressive containment and social distancing strategies that they initiated when their outbreaks were small. When their outbreaks were like what we have in Canada right now.”

When referring to the lack of ventilators in Ontario, and Canada in general, caution was expressed. “There are a lot of people, like in the situation that they have in Italy, who die because we just can’t care for them,” Dr. Fisman stated. “Our case numbers are an echo of what’s happening in other countries around the world, particularly the United States. So we are importing cases in an exponential manner, and each one of those is spark that can set off a Canadian epidemic. There is a high likelihood that that is going to happen in the coming weeks, in fact it may have happened already.” 

“We don’t have to be like Italy, we have a choice right now on how we fight COVID-19. We can act proactively when things are quieter, and we’ll be criticized for overreacting. Or, we can wait until we are in a crisis like Italy, and react then, at which point we’ll be in a very deep hole that we’ll be digging ourselves out of. And people will die predictably.”

The solution is pretty clear, and thankfully it’s one that Quebec has encouraged since last week.

“We [all] need to move to social distancing now. That’s why we need to move to school closures, that’s why we need to move to work from home. That’s why we need to move to enforced cancelation of large public gatherings. We don’t have to be perfect, this doesn’t have to be martial law. But this all works much better if you do it sooner, and it doesn’t have to be perfect. At the end of the day, this is not that transmissible a virus. It has a reproduction number of two, which means each old case makes one new case before it gets better. We need to push that to one. We can do that very simply by having contact numbers. And Canadians have half the contact numbers now than they did before this epidemic broke out. It’s pretty straightforward what the math is.“

“This is the golden time of Canada. Before our golden time runs out, we need to act. We don’t need to be Italy, we don’t need to be France, we don’t need to be the U.K. in the fight against COVID-19. This is our golden time to act, and we need to act when things are still quiet, so that we are not reacting to a crisis. Proactive not reactive.”

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