Life in a state of emergency

News

1. State of Emergency

From yesterday’s COVID-19 update:

• Premier Stephen McNeil has declared a State of Emergency, invoking the Emergency Management Act;

• McNeil limits all public gatherings to five people;

• effective today at 6am, anyone who travels into Nova Scotia from outside the province must self-isolate; screeners will be placed at the airports, ferry terminals, and the roads into Nova Scotia to tell people of the requirement;

• Chuck Porter, the minister overseeing the Emergency Management Act, has given authority to police to arrest people and businesses violating the social distancing recommendations, and to issue summary offence tickets, with fines of up to $1,000/day for people and $7,500/day for businesses;

• all provincial parks are closed (more on this below);

• there are seven new cases of COVID-19, bringing the total in Nova Scotia to 28; all of them are either people who have travelled or people who have come in close contact with people who have travelled;

• local testing for COVID-19 at the QE2 Health Science Centre can now report positive and negative results as “confirmed” without being sent to Winnipeg.

I’ll be on the daily briefing conference call throughout this crisis.

I have comment, but please understand that I am not an epidemiologist, and the following is my interpretation of what the province’s chief medical officer, Dr. Robert Strang, and the premier say at the daily briefings.

First, we should expect the number of positive COVID-19 cases in Nova Scotia will soar this week, as the incubation time for the coronavirus elapses for those who have travelled for spring break and other trips.

If everything works perfectly, all those people will self-isolate from the moment they arrived in Nova Scotia, and the virus will not spread much further than from the travellers and those around them.

That’s unlikely.

None of the officials said this, but my fear is that many of those who will go into self-isolation will say to themselves, “well, if I’m going to be at home for two weeks, I first need to stop by the grocery store to stock up…” Which will inevitably lead to further spread.

What about community spread? “Community spread” means people start testing positive who have no clear connection back to someone who has travelled. Strang has repeatedly said that 1) there is not yet community spread, and 2) he fully expects community spread to appear.

Lots of people have pointed out that without widespread testing, there’s no way to know if there’s already community spread. I pressed Strang on that point Thursday:

In fact, the province’s 811 self-screening site excludes from testing anyone who has not travelled outside the province or who has come into contact with someone who is either infected or who has travelled outside the province. So how can you [Strang] categorically claim there is not community spread of COVID-19 in Nova Scotia? His response:

Well, that’s always a possibility. But based on what we knew as we built our approach, the virus wasn’t here, so we are aggressively testing people who are coming into the province.

We’re also looking at other indicators of potential community spread. So we’re monitoring rates of people going into emergency rooms with influenza-like illness, which is part of our standard influenza surveillance. And we’re getting daily reporting on that from all of our hospitals; if we see a spike in flu-like illness in any community, we’re certainly prepared to go in and do some testing, but we haven’t had to do that.

If we get an outbreak in a school before they close or in a long-term care facility, along with our regular viruses, we’ll now be testing for COVID.

We are now testing anyone who has to be admitted to hospital with respiratory illness for COVID.

So even though we’re not testing people with just fever or cough, we’re looking for community spread in a number of other ways. And we’re actively looking at how do we do that more community-based testing in certain locations. There’s nobody around the world that is testing everybody with a fever or cough, that’s just not realistic or feasible. So we have to focus the resources we have in the most appropriate places.

Obviously, there is some constraint on testing, and I hope to understand that better in coming days — I’m promised an interview with an expert tomorrow — but I asked Strang yesterday why people returning to Nova Scotia aren’t at least having their temperatures taken at airports. He answered that such checks are useless in detecting coronavirus, as symptoms usually don’t appear for some days after arrival.

But the expected increase in COVID-19 cases this week is the least of the worries. There are now just two people in hospital with COVID-19, and a third person who was hospitalized has returned home. Hopefully, this week’s new cases will not be a problem for the hospitals to handle.

It’s down the road that’s the worry. I can almost see the fright in Strang’s and McNeil’s faces about this.

All along, Strang has said the crisis point is six to eight weeks ahead, now five to seven weeks. Unless we “flatten the curve,” late April and into May is going to be hell, and let’s not mince words: we’re talking about a health care system overwhelmed, people dying at enormous numbers, doctors making decisions about who lives and dies because we don’t have the ventilators to keep everyone alive. Doctors and nurses and other health professionals will themselves contract the disease, reducing their ranks. You will know people who die. I will know people who die. Everyone will know people who die. Tons of people will be sick at home, or caring for sick people at home, or both. It will be an enormous tragedy that is now unimaginable.

The state of emergency is intended to prevent the worst of that. If successful, yesterday’s order — and undoubtedly, the orders and restrictions to come — will slow down the transmission rate and spread wider infection over months rather than weeks. We’ve all seen some version of this graph:

By slowing down the transmission rate, we will increase the ability of hospitals to treat people, saving many lives.

Take this seriously.

Last week, Strang detailed how we should be behaving:

“It’s this progressive layer of distancing, from all of us doing social or physical distancing all the way through a case who is strictly self-isolating within their home,” explained Strang.

Level 1: Everyone

All of us need to be social distancing. We call it social distancing, but really it’s physical distancing — we actually physically get away from each other, reducing the chance of the virus being transmitted.

That means things like, as much as possible, working from home. It’s why we’re closing down so many things, minimizing the chance of groups of people getting together and spreading the virus.

That’s something we all need to do, that physical distancing. But it’s also a time when we actually have to be more socially connected to each other. This is a difficult time. We should be using our devices, using the telephone to connect with each more, so we’re supporting each other.

But it’s important to recognize that social distancing doesn’t mean people can’t be out if necessary. We still need to go get groceries. People who can, who are not self-isolating, need to support others who do need to be self-isolating, whether they’re self-isolating because of travel, or maybe they’re a senior or someone who is immune compromised, those for whom it’s more important that they stay home.

So people can still be out and about doing those essential things.

Level 2: People who have travelled

The next layer is people who have travelled and are being asked to self-isolate. It doesn’t mean that they have to stay in their home. If you’re in self-isolation just because of travel and you’re feeling well and you don’t have any symptoms, you can still take your dog for a walk, go for a bike ride, take your kids to the park.

What’s really important is that people are separating from each other. You don’t have to stay 24 hours a day behind your door in your home.

Layer 3: Close contacts of a known case

The next layer is, once we have a case, we’re going to identify who they have been in close contact with. Close contacts of a known case are more likely to have been exposed and are going to get sick, so it’s even more important that they are more vigilant about separating from others, and need to stay more in their homes.

Layer 4: People who are infected

This is people who are symptomatic and they’ve gone to be tested, and they’re waiting for the test result, or they’ve gotten the test result back and they’re positive. Those people need strict home isolation, so they should not be out and about.

Even within their home, it’s very important that as much as possible, that they’re separated from other people within their home — in a bedroom, if possible, with their own bathroom. People who are coming into close contact with the person who is sick, if they’re able to get a mask, have a mask on. Really careful hand-washing and cleaning in the home.

2. Criminalizing the marginalized

“It is clear that serious measures must be taken to ensure the virus isn’t spreading,” writes El Jones:

The strongest public health response is necessary, and this requires collective effort and social responsibility.

However, when health issues become criminalized, historical evidence shows that vulnerable people become increasingly victimized. This outcome can actually run counter to public health aims.

Click here to read “We face a public health emergency, and criminalizing the marginalized can worsen the crisis.”

3. Going outside

Strang, the Chief Medical Officer of the province, has repeatedly said it’s good to get outside, and to the park. And I’ll repost here what he said in terms of self-isolation, and this is a quote:

The next layer is people who have travelled and are being asked to self-isolate. It doesn’t mean that they have to stay in their home. If you’re in self-isolation just because of travel and you’re feeling well and you don’t have any symptoms, you can still take your dog for a walk, go for a bike ride, take your kids to the park.

What’s really important is that people are separating from each other. You don’t have to stay 24 hours a day behind your door in your home.

[emphasis added]

And that’s for people who are self-isolating, not for the vast majority of us who are not self-isolating but who should be practicing social distancing. At nearly every briefing, Strang has said we should be getting the exercise we need, going out on that walk or bike ride, or working in the garden or going to the park. (I saw some people cleaning up their gardens yesterday, but it’s a bit early to do real gardening — there’s snow in the forecast!)

But let’s stress it again: while you can go for your walk or bike ride, be sure to socially distance yourself from people you don’t live with. Keep that six-foot separation.

For myself, my daily walks are part of my self-care. I see this thing lasting a very long time, and I need to be at my best; I need exercise and sun. So every day, after I report on the daily briefing, I head out the door and walk around Dartmouth. Yesterday, I walked up Windmill Road, then up Albro Lake Road to Mic Mac Boulevard, walked around Crichton Park School (which somehow I didn’t even know existed before), then back around the perimeter of MicMac Mall and that nice trail over the foot bridge around Lake Banook, and then back down Prince Albert Road to my house. It took about an hour and a half. Along the way, I didn’t touch a thing, not even those damnable crosswalk pushbuttons, and while I passed a couple of dozen other people similarly getting their exercise, we all kept our distance, giving each other wide berth while shouting hellos.

According to the province’s chief medical officer, there is nothing wrong with this.

But there’s a lot of shaming going on, for people going outside.

A flash point hit on Saturday, when lots of people headed to beaches and parks to get their bit of sunshine and exercise. To be honest, I was thinking about driving all the way to Taylor Head and walking around there myself, but work duties interfered, so it was just a short walk around the neighbourhood instead.

Anyway, as I see it, it made perfect sense for people to want to get out and enjoy an unusual sunny winter day, especially as Strang had said it was OK to “take your kids to the park.” The problem was that just too many people went to the same parks: Crystal Crescent Beach, Point Pleasant Park, Lawrencetown. We can argue about whether people socially distanced themselves correctly there, but especially on trails leading to and from parking lots, social distancing would be nearly impossible.

Worst, as McNeil tells it, people “disregarded” police warnings about going to such places. He provided no details.

And so, the premier ordered all provincial parks closed.

Which I understand, but I wish it hadn’t had come with such social shaming.

There’s a great desire to call people out on not self-isolating — I get emails every day about this person or that person who is contravening the self-isolation after travelling order. Several times over the past week Strang has been asked about it himself, and each time, he’s been careful to say we should not shame people or name people publicly. He says instead that we should be of generous spirit, see if they are not self-isolating due to some circumstance in their life, and offer to help. This is the right attitude, I think, and Strang is here talking about people who have travelled and should be in self-isolation — for whom, incidentally, he said it was OK to go to the park — and not people under no such self-isolation order and who just want to go for a walk or be outside.

McNeil and Strang have been very good about warning against shaming, and again, Strang had said it was OK for people go to the park.

So it was unfortunate that McNeil expressed anger at those who followed what seems to have been Strang’s blessing and went to the park. McNeil could’ve said something along the lines of, “we understand that people want to get outside, but this isn’t the way to do it, these places are too crowded, so we’re closing the parks” or “given our stepped up concerns, the advice we gave last week to go to the park no longer holds, and under this state of emergency, the parks are closed.” Instead, he castigated people.

And now, the city has likewise closed all municipal parks and trails. So, we’re left to the sidewalks, which is what I’ve been doing anyway.

I find that “it’s OK to go out for a walk, but just keep your distance from other people” is simply too nuanced of a statement, and I’ve already been condemned for saying it.

But if we get an order preventing us from walking on the sidewalk, I will fall apart completely, physically and emotionally.

4. The economy

“The government of Canada announced its COVID-19 economic aid package on Wednesday,” writes Erica Butler:

I called Lars Osberg, professor of economics at Dalhousie, to get his thoughts on the measures, the economic crisis the pandemic is causing, and what it might mean for the future.

“From what I’ve been able to see, it’s good with what they are doing,” says Osberg. “The question is whether it’s adequate to the task.”

…

“This idea that you defer tax payments for six months,” says Osberg, “it’s the bulk of the $82 billion.” But a deferral mechanism makes more sense in the short term. The deferral does provide “an injection of purchasing power into the economy,” says Osberg, “which is appropriate if you only have a very short term shock. And that’s a very optimistic scenario.”

The same goes for payment deferrals being offered by mortgage banks and utilities. If this all means that in six months’ time people will need to double up on payments that start to come due, then we are actually postponing the economic shock.

“It’s just coming out of your pocket a little bit down the road, which is when we would have hoped that there would be a recovery phase from the short, sharp recession,” says Osberg. “So if you only spend in the short term, you only get very short term results.”

5. Pregnancy and birth in the age of coronavirus

“Lack of pre-natal and delivery supports and concerns about social isolation worry those who are pregnant and at home with babies,” reports Suzanne Rent.

Click here to read “Baby on board! Pregnancy and birth in the age of coronavirus.”

6. Who should live and who could die?

“Last week, a friend emailed me with what he suggested was an idea for an Examiner column,” writes Stephen Kimber:

I’d been meaning to contact him. We usually get together a few times a year for lunch and the opportunity to share our inevitably smarter-than-those-in-charge solutions to the world’s political, economic and social problems. And, oh yes, to have a good meal and enjoy each other’s company. When his email—Subject line: “Old Farts” — landed in my inbox late last week, I realized with a now suddenly all-too-familiar unfamiliar startle that we wouldn’t be enjoying lunch together anytime soon.

He quickly came to his column-idea point: “I am 81 and have underlying health issues,” he wrote. “I am not afraid of dying but get twitchy when I hear health professionals tell me in the media about shortages of ventilators and ICU beds in Nova Scotia. These shortages, they say, may ‘force’ these docs and nurses to decide to let people like me die and give the care to thirtysomethings.”

As someone who has known an up-close thing or two about the law and our Charter of Rights and Freedoms, my friend made the point that “any life-and-death decisions that did not give us old farts a chance to survive might be quite illegal… I think a good class-action lawyer like Ray Wagner could craft a very lethal lawsuit against the health professionals and the health authorities, claiming the Charter rights of old people were being violated by deciding that health care should be arbitrarily withheld from them.”

Well, yes, indeed, but… what are our real options? Now?

Click here to read “COVID-19: who should live and who could die?”

7. Racist tropes

“For the past week, as criticism of Donald Trump’s handling of the coronavirus crisis has intensified, Trump has deliberately emphasized calling the disease the ‘Chinese Virus,’” writes El Jones:

Trump’s strategy deliberately racializes the disease, and singles out and scapegoats Chinese people. The tactic stokes fear and hatred against Chinese (and Asian) people at a time where people are angry, anxious, and facing instability.

You haven’t really experienced covering a pandemic until you receive messages from readers accusing you of *checks notes* being a Chinese sleeper agent living in Canada to spread “fake news.”

Emergencies can bring out the best and worst in people.

— Alexander Quon (@AlexanderQuon) March 19, 2020

The impact of racist narratives about coronavrus are not limited to the United States. People of Chinese descent in Halifax report experiencing racist comments and hostility as some people blame them for the outbreak.

Click here to read “Racist tropes about COVID-19 echo the long history of anti-Asian stereotyping.”

8. Stranded

“Indigo Christ desperately wants to come home to Halifax, but even more immediately, she wants to speak with someone from the Canadian embassy in Guatemala, or in Global Affairs Canada in Ottawa who can at least let her know what – if anything – is happening to help Canadians stuck in the Central American country get home,” reports Joan Baxter:

Christ is stranded in Guatemala along with two other women, Laura Robinson from Rothsay, New Brunswick, and Lenora Yarkie from Edmonton. The three were working in Guatemala as cooperants with the Maritimes-Guatemala Breaking the Silence Network (BTS) that supports human rights and community development programs of partner organizations in Guatemala. They were working with communities in the south of the country that have been negatively affected by the controversial, Canadian-owned Escobal silver mine.

In a Whatsapp call today from the Airbnb where they are staying in Guatemala City, Christ told me that they have been trying since Tuesday this week to reach and speak with someone from the Canadian embassy or the Canadian government.

All their attempts have been in vain.

Click here to read “Maritimers stranded in Guatemala frustrated by Canadian government silence.”

I don’t think it’s the worst thing to be stranded in such places. Obviously, everyone is worried, and people want to be home, but the people in Central America are hospitable, and I’m supposing that their governments will do what they can for Canadians and others struck there. Not the end of the world. But I do think it’s an interesting story. The Canadian government is sending mixed messages, probably because it’s overwhelmed.

9. Farmers’ markets ask for volunteer help

“Nova Scotia’s Farmers’ Markets are moving online, and we could use community support as we move rapidly to support Nova Scotia’s farmers and producers while helping to provide food and necessities to Nova Scotians,” says Farmers’ Markets of Nova Scotia, the umbrella organization for the province’s farmers’ markets:

If you or someone you know can help with order packing, doing safe door-to-door deliveries, or provide technical support from your home, please sign up here to help!

Please share our volunteer drive with individuals and groups in your community! Thanks for helping get the word out!

*Please note all volunteers will be provided with a comprehensive guide for safe practices and social distancing.

Noticed

I watched an entire concert by Jason Isbell and the 400 Unit on Saturday. How could we survive this thing without the internet?

Also, neither here nor there, but I’ve seen Amanda Shires a dozen times, once in person, and while always fantastically talented and wondrously beautiful, she never looks like the same person.

Government

All government meetings are cancelled this week.

On campus

All events are cancelled.

In the harbour

03:00: Ainazi, oil tanker, arrives at Imperial Oil from Antwerp
05:30: Siem Cicero, car carrier, arrives at Autoport from Emden, Germany
09:00: Dalian Express, container ship, arrives at Fairview Cove from Norfolk
14:00: Tropic Hope, container ship, sails from Fairview Cove for Palm Beach, Florida
22:30: Dalian Express sails for Dubai

Where are the Canadian military ships?

Footnotes

Be kind.