To help combat COVID-19, we need a preplanned lockdown. I’m calling for a ‘Covatical’

Vincent Lam, The Globe and Mail
September 18, 2020

Covatical

PHOTO ILLLUSTRATION: THE GLOBE AND MAIL. SOURCE IMAGES: ISTOCK

n Withrow Park in east-end Toronto, there was a square-dancing class last Sunday. The windy summer afternoon provided plenty of air circulation to blow away strands of COVID-19. To maintain physical distancing, masked dancers wielded long foam batons and tapped their ends, rather than holding hands. The human species is adaptable, and will get through the current pandemic. The question is, how best to dance to the music we are given? The summer reprieve from the COVID-19 “lockdowns” of the spring is waning. As schools open across the country, and COVID-19 related restrictions ease, two questions being asked are: Will case numbers go up? Will we need to lock down again?

The first question is already answered: Daily new cases of COVID-19 are on the rise. As for the second question, on Tuesday, federal Health Minister Patty Hajdu promised a “much more surgical approach” to future lockdowns, with these to be triggered by local or regional spikes in the number of COVID-19 cases. The suspense will kill us if COVID-19 does not. Rather than waiting to see whether a reactive scramble to “lockdown” affects each of our communities, let’s answer the second question right now. Let’s decide to plan and schedule the next broad lockdown to our best advantage.

We need a better name, as “lockdown” evokes school shootings and prison riots. Instead, let’s take a cue from academia, wherein every few years professors enjoy a sabbatical – a planned paid leave in order to reflect, refresh and be enriched for their return to work. From early December, 2020, to early January, 2021, we should have a “Covatical.” As in the spring of 2020, as many Canadians as possible should stay at home as much as possible, minus the panic. This will serve to drive down the COVID-19 infection rate, which we can predict will have increased, so that we can emerge brightly into 2021.

Step back from the daily COVID-19 headlines, and consider the big picture lessons from the first six months of the pandemic. Lesson one: Broadly implemented physical distancing works. New reported cases of COVID-19 in Canada ranbetween roughly 1,400 and 1,800 a day in late April. Our spring “lockdown” drove these numbers down into the 200 to 400 range during August. As restrictions have eased, daily cases are rising into the 800s. Over all, this has been a success. Thanks to the “flattening of the curve,” the health care system has not been overwhelmed. We are in a position to reopen schools in-person. The economy has taken a hit, but is not crippled. In the absence of an effective vaccine or a definitive treatment for COVID-19, our most powerful intervention has been the co-operation of each of us with public health restrictions. The corollary of restrictions working is that when they are lifted, they don’t.

Lesson two: Widespread shutdowns have a significant cost, both public and personal. The Parliamentary Budget Officer forecasts an unemployment rate of 10.6 in the fourth quarter of 2020, compared with a rate of 5.7 during the fourth quarter of 2019. The cracks in our society have widened, as Canadians who are vulnerable, socially isolated, or economically precarious have suffered disproportionately. Businesses predicated upon the physical attendance of patrons, such as the restaurant and hospitality industry, are facing an existential threat. Families who are trying to educate children at home, care for vulnerable family members, while remaining healthy and solvent, are exhausted.

The question to ask is: If another lockdown is likely in the cards, can we preplan and preschedule it as a “Covatical” and benefit from a reduction in COVID-19 transmission while averting many of the harms of suddenly imposed interruption? Lesson three might then be: a predicted interruption in activity does not have the same negative effects as a hasty one. Consider France, which largely shuts down each August. More than half of French vacationers take their holidays in August, which empties Paris, and reduces the industrial production of the country by a full third during that month. This surprises some North American tourists who discover that shops are closed, but it does not wreak havoc upon French society or their economy. Surprise disruption is what causes chaos, not merely a pause in activities. If we choose a preplanned Covatical, rather than a hasty and panicked lockdown, we can plan and provision ourselves for it in advance. We can better protect the vulnerable. We can insulate Canadians and our economy from the impact of a predefined period of reduced activity.

With advance notice, essential businesses and services can plan in advance how best to operate – what functions to increase in November, and what to move to work at home in December. Supply chains and households can adapt in a reasonable way. No need to buy a year’s worth of toilet paper, because everyone knows the Covatical will last for one month. Teachers can preplan remote learning. Vulnerable members of society can be identified and provided for. Elective surgery capacity can be increased pre- and post-Covatical, and need not be cancelled suddenly. Industrial production can be similarly managed. A suddenly announced lockdown just prior to Christmas could easily occur, given current trends, and would be disastrous for many already-suffering retailers. However, knowing the schedule in advance will mean that everyone gets their shopping done earlier and hopefully pushes some retailers' balance sheets into the black for 2020. Financial markets, which react badly to surprises, will include the anticipated Covatical slowdown in economic forecasts. The French stock market does not crash every summer.

Why should a Covatical take place from December to early January? Part of the benefit will be to include the usual start of influenza season, so the Covatical will dampen the transmission – and additive risk – of two potentially deadly respiratory infections. This timing will bridge school holidays and a period when most people take some time off, making it less disruptive to businesses, education and families. Agriculture will be less affected during the middle of winter. Meanwhile, all holiday office parties, large extended family gatherings, mass religious services and other seasonal festivities will have to take place virtually. This will both eliminate the significant COVID-19 transmission risk of these gatherings and delight introverts. We should permit fixed bubbles of 10 persons during the Covatical, so that families can care for elderly or otherwise vulnerable persons, and be a little less isolated. Four weeks comprises two maximum incubation periods of COVID-19, providing enough time that most new cases within a bubble will be identified before leaking out of that bubble.

Why a national Covatical instead of a “surgical approach” reacting to spikes in cases? Importantly, we already know that broad intervention works. Meanwhile, in a complex economy, an approach targeted toward specific regions or industries will still cause disruption beyond the target. If there are outbreaks linked to public transit, can we close public transit without disrupting a city?

The Canada Emergency Wage Subsidy and other financial support programs will have to be revived for a month. Lest anyone suggest this is impossible, note that this would be an anticipated expenditure whose costs can be projected, rather than what we entered into in the spring of 2020 – a potentially open-ended financial hole. And we did it. To put things in context, Canada’s debt to GDP in 2020-21 is forecast to be 44.4 per cent. This of course has risen thanks both to COVID-19 and low oil prices, but is still far below the peak of 66.6 per cent seen in 1995-96. The benefit of driving down COVID-19 infection rates significantly via Covatical will be to have more latitude to open broadly again in early 2021.

Some will ask, what if we would not have needed to go into lockdown? Will we have done the Covatical for nothing? A core paradox of all public health intervention is that the more successful it is, the more likely it may afterward seem to have been unnecessary. In preplanning a Covatical, we will have to accept we will never know if we would have otherwise been forced by COVID-19 into lockdown.

Another conundrum in public health is that pandemics of new strains of respiratory infections are actually predictable, but the political cycle is shorter than the necessary duration of interest in these events. Four influenza pandemics occurred in the 20th century. Four to six far-reaching respiratory outbreaks occurred in most past centuries, whether due to influenza, coronavirus, or other respiratory pathogens. It happens every couple of decades, while elections take place much more often, hence the worldwide scramble for personal protective equipment and ventilators in the spring of 2020. COVID-19 forced us to be reactive, and we remain largely in that mode. If we wait to be triggered into lockdowns, this will likely happen when health care systems are being overwhelmed, contact tracing is not keeping pace with new infections and new clusters are appearing without warning. Rather than sticking to our reactive instincts, and waiting for subsequent waves of COVID-19 to drive us to panicky and unnecessarily damaging lockdown, a Covatical is an opportunity for us be pro-active during this crisis. If things are getting out of hand when the Covatical starts, we will be glad we planned it. If everything is under control, we will solidify our gains. We didn’t choose this music, or the dance partner, but now that we have had one go around the floor, let’s lead the next dance.