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Lessons from COVID-19: We are only as strong as our weakest link

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Image: NIAID/Flickr

There is a lot we still don't know about COVID-19 (coronavirus) and how hard it will impact Canada. But one thing we're learning: we are only as strong as our weakest link.

COVID-19 is exposing a number of weak links globally and here in Canada.

For starters, critical to containing COVID-19 are two new 2020 buzzwords -- social distancing and self-isolation. Health officials are asking people to do their part by staying home if they're sick and preparing to have two weeks' worth of medicine and provisions.

While staying home is known to help curb the spread of COVID-19, it's hard advice to swallow if you're poor, working poor, in the service industry or self-employed.

As Hamilton Roundtable for Poverty Reduction director Tom Cooper points out in this Hamilton Spectator op-ed, the working poor can't afford to take unpaid time off and people on fixed (low) incomes -- such as people on social assistance -- don't have extra cash to stockpile provisions.

"If we truly want to keep our communities healthy and protect against the spread of illness, whether COVID-19 or anything else in the future, we need to pay more attention to the relationship between health and income inequality in Canada," Cooper writes.

It's not just the poor who face barriers. Precarious workers have challenges too.

Jon Shell, managing director and partner at Social Capital Partners, points out that self-employed workers will suffer from COVID-19.

"Spare a moment for the self-employed today as you focus on not touching your face," Shell tweeted. "They can't avoid travel, need to go to client sites, and get no income if they self-quarantine. No corporate support and our social support system isn't designed to help them at all.

"We constantly push people to be 'entrepreneurial' and to 'hustle.' Let's remember that the lack of an appropriate and fair safety net for the self-employed is one of the many things this crisis is exposing. We need to fix it."

In this Toronto Star column, Jim Stanford, director of the Centre for Future Work, points to the need for legislated sick pay, better job security for workers who may need to follow the 14-day self-isolation COVID-19 protocol and better employment insurance provisions for workers who cannot work because of illness.

Legislated sick pay is key: research shows that cities and states in the United States that require employers to provide paid sick days have fewer flu cases.

Getting rid of the need for doctors' sick notes is also key. Why flood doctors' offices with sick people when they should be at home resting and not spreading contagion?

COVID-19 could rock the global economy

Speaking of contagion, fears over COVID-19 and an oil sell-off led to panic in the stock markets Monday, forcing the New York and Toronto stock exchanges to briefly halt trading.

In the U.S., United Airlines and Jet Blue Airlines are cutting back flights due to a drop in demand due to COVID-19 fears.

Meanwhile, the U.S. Federal Reserve and Bank of Canada have cut interest rates in an attempt to protect the economy from a COVID-19/oil sell-off downturn.

Businesses are cancelling travel, conferences and meetings in response to the COVID-19 threat.

It's a reminder that the economy is only as strong as the health of our communities. And as Italy completely shuts down, COVID-19 is teaching us that we are only as strong as our weakest link in the global public health chain.

That's why investments in public health -- disease prevention, health promotion and protection -- are so critical.

Cuts to public health hurt

It's a lesson that seems to have gotten lost in Canada, all these many years after the SARS outbreak.

Across Canada, provincial governments have cut back on public-health spending. Just last year, the Ontario government made a move to slash public-health budgets and the Alberta government is in the process of implementing similar funding cuts. Other provinces have also seen dwindling public-health investments over the past decade.

The irony of public health is that it's undervalued until an invisible virus emerges, making the value of public health visible. After SARS, that visibility led to new investments in public health, but over time, funding has dwindled.

This Springer article says "governments around the world underinvest in public health and public-health research."

In the OECD, health spending for prevention is rarely higher than six per cent of the health care budget. In Canada, only 5.5 per cent of total health spending goes to public health, such as food and drug safety, health inspection and health promotion.

Trevor Hancock, retired public health professor at the University of Victoria, calls the underinvestment in public health short-term thinking.

"There are several factors at play, one of which may be that public health does not generate headlines, whereas dramatic life-saving interventions do," Hancock writes.

"When public health is effective, nothing happens; nobody writes headlines about the hundreds of cancers that did not happen, only about the latest hi-tech drug or intervention that reduced the death rate from cancer."

The advent of COVID-19 is helping us see public health in a new light.

When it comes to trying to contain COVID-19 spread, we have strengths. Canada's public-health professionals took many lasting lessons from the 2002-2003 SARS outbreak and they are better prepared for COVID-19 than some countries.

Protocols were in place to quickly identify potential COVID-19 patients and the source of infection, test them, treat them in hospital if needed and, otherwise, ensure they’re self-isolating for 14 days. Even jurisdictions in the U.S. are struggling to meet these basics.

Communications from public-health officials in Canada have been steady, transparent, and reliable. In times of uncertainty, trust is key.

In order to maintain trust, Canada's public-health system needs to be better funded over the long haul. In the short term, expect pressure on the federal and provincial governments to respond to the dual crisis of COVID-19 and oil sell-off with major stimulus initiatives.

Economists are already talking about the need to "supersize" refundable tax credits like the GST or the Canada Child Benefit, to get cash in the hands of those who need it. But this is also a moment to correct the chronic underfunding of public-health units across Canada.

If we manage to contain COVID-19, it will be because of individual efforts to follow public-health protocols and because of the expertise of public-health officials in quickly establishing those protocols.

These are our strongest links in the system. Let's invest in keeping them strong.

Trish Hennessy is executive director of Upstream. This article first appeared on behindthenumbers.ca

Image: NIAID/Flickr

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