The Virulence of Human Decision

As I sit here and write this, the numbers of active COVID-19 cases in Canada are rising to unprecedented levels, with new viral variants emerging, and younger people being affected and suffering in ICUs, unlike anything we witnessed in the first and second waves of this pandemic. This rise in transmission is occurring despite an ambitious roll out of vaccinations throughout our country.

We are all tired. We are tired of these restrictions, and the suffering that has arisen within this container of COVID — social isolation, financial hardship, uncertainty, and fear. So many of us are struggling right now. So many of us are missing the connections that we all depend upon for joy and meaning in our lives. And while we all crave a return to our ‘normal’ activities and gatherings, the path forward seems strewn with obstacles of our own making.

Facing Facts

We all face a few basic facts. In order for there to be a return to any semblance of normality in the functioning of our society, we need our COVID-19 numbers to go down. Higher COVID numbers translate to increased serious disease, hospitalizations and deaths. Increased hospitalizations threaten to overwhelm our finite healthcare resources, such as ICU beds, ventilators and staffing. When such healthcare resources are overwhelmed, then rising numbers of serious infections, and other urgent care needs, cannot be adequately managed, and more people will die. Governments cannot, and will not, loosen public health restrictions whilst active COVID cases soar.

While there is a rising concern with COVID 19 variants, and their increasing virulence and transmissibility, we must understand that it is the nature of viruses to mutate. When there are greater viral numbers in a population, there is a greater chance of mutation and, henceforth, the emergence of variants. The longer a virus remains in circulation, the more likely variants will emerge. Loitering in complacency only gives this virus an upper hand.

Our current public health strategies of physical distancing, wearing masks, washing hands and the isolation of ill individuals have been the foundation of global infectious disease control for millennia. These same measures have been used to control ancient outbreaks of leprosy, polio and plague. In our more recent history, the Spanish Flu of the early 20^th century had varying levels of devastation depending upon how well people in a community adhered to these basic public health measures. In 1918 the influenza fatality rate of St Louis ended up significantly lower than that of Philadelphia, even though Philadephia had fewer cases. The authorities in Philadelphia decided to downplay the rise in serious flu cases and allowed a large parade to take place downtown, with 10 000 people in attendance. Within one week of this parade a surge of deaths was recorded unlike anything officials saw before or after that time in that pandemic.

If we look at the current world stage, there are countries such as New Zealand, Australia, Vietnam and Taiwan that have returned to relatively normal levels of gathering, and have eased requirements of masks and other public health restrictions in response to reduced COVID numbers. In each of these cases citizens adhered to the public health advice of their governments who generally had strict enforcement of travel restrictions, quarantine, and fines for those who refused to follow the recommendations which were, ultimately, for the benefit of all.

Counter Narratives

The barriers to overcoming this COVID-19 pandemic in Canada now lie less in the nature of the virus and more in the nature of our humanity. 

One of the principal human obstacles we face is the contagious belief in counter narratives. Many intelligent people have chosen to accept a narrative that COVID is not real or serious; that masks are not effective; and that there is conspiracy and conflict of interest by many powerful people who benefit from perpetuating this global story of pandemic. This narrative spreads like wildfire through social media and, within the context of our common fatigue, it becomes that much easier to believe. This belief has tragically led to non-compliance of public health measures, to unsafe gatherings and, predictably, to further spread of COVID-19.

As a physician I witness the effects of COVID daily. I speak with the physicians and nurses who staff the emergency rooms and ICUs that continue to have COVID related admissions. I work with the health care workers who are burned out from the weight of care demands and long work hours over this past year. And I see the patients in my practice, suffering with their isolation from loved ones; the financial hardships of lost jobs or reduce income; and the trauma of addiction and broken relationships. There are days when I wish that a COVID denier could sit in the midst of a crowded ER, or an ICU at capacity, with people – mothers and fathers, grandparents, children – struggling to breathe, or tearful at the suffering, or loss, of their loved one.

Perhaps there are conflicts of interest, and power politics, at play during this COVID pandemic. And yet what is the probability that every world nation, state, and society would collude to disrupt economies, bankrupt future generations, and enforce a narrative that has created so much death, despair and suffering?            

‘Me’ vs ‘We’

The second obstacle to overcoming this pandemic is the assertion of individual rights over the needs of the collective. Does anyone really want to have to wear a mask? Is there anyone out there who would choose to be separated from their loved ones? Do any of us enjoy the limitations of our movements and travel? I feel sadness and anger when I watch the marches of anti-maskers claiming personal rights.  Wearing a mask during a pandemic is not about you as an individual. It is about the community in which you live. Wearing a mask is an act of kindness. Physical distancing is a gesture of care for others.   As Gandhi reminded us, ‘the true measure of any society can be found in how it treats its most vulnerable members.’  When we constrict our perspective towards our own needs and preferences, and away from the common good, we become the unwitting perpetrators of this continued suffering.

The Politics of Not Doing Enough

The final human obstacle that we must address is that of inaction. Countries, and other jurisdictions, who are now seeing lower COVID numbers and an easing of public health restrictions, had firm measures in place to stem the spread of this virus. Strict limitations of travel, quarantining, mandatory mask wearing, and avoidance of any gathering have been the tried and true measures of success on this global pandemic stage. Our provincial and federal governments need to take swift and decisive action to close down all travel, to restrict border crossings, and to enforce public health measures with stricter consequences. Left to our own devices, too many are ignoring, or making exceptions to, the rules. Foreign COVID variants now make up 40-50% of our cases, affecting younger populations, and leading to greater transmission. We cannot wait any longer for everyone to make the right decision on their own. Too many are suffering.  A government’s responsibility is to protect the citizenry which it represents. Its mandate is to put in place measures that are, ultimately, for the common good. History will remember the leaders who made difficult and courageous decisions, even when these were unpopular at the time. Political posturing has no place during a global pandemic.

A Unity of Purpose

Indeed, we are all tired of COVID.  The numbers of opioid overdoses, suicides and cases of domestic violence point to the cracks in our collective ability to cope. And yet the only way out of the current public health restrictions is to work together towards decreasing the number of active COVID-19 infections. This requires us to reconsider our beliefs and our actions.

COVID is real. Ignoring its reality will not make this pandemic, nor the public health restrictions, go away. We must instead focus our attention on how our individual decisions are affecting the community of which we are apart. We are all in this together, and it is only together that we can get out of this. Now is the time to gather with one voice and one purpose. Now is the time to pressure our governments to follow the examples of other nations in restricting our movements and physical contact in the short term, in order to reduce our suffering for the long run.

With vaccinations now available we have the potential to significantly reduce transmission of this virus, and to move beyond this difficult period. The only limitations are the ones we ourselves continue to perpetuate. The opportunity and responsibility to begin to heal as a nation, and as a people, lie in the decisions each of us make on a daily basis.