People wear face masks as they walk in Montreal, Dec. 4, 2021.Graham Hughes/The Canadian Press
Much has been written about the impact on public opinion, particularly as it relates to the COVID pandemic, of misinformation: false or distorted data, spread via social media, purporting to show the pandemic is exaggerated, or that the measures taken against it are ineffective or even harmful, or that other, “alternative” measures would be more effective.
Rather less has been written about another phenomenon whose impact on public opinion has been just as profound: misinterpretation. Disinformation relies on a network of true believers and conspiracy theorists, egged on by anonymous bots of dubious origin. Misinterpretation relies only on the universal human inclination to look for the easy out, to confirm our prior convictions, to believe what is most comfortable to believe.
The sudden surge in the pandemic, nearly two years after it began, owing to the emergence of the highly transmissible Omicron variant, has made for something of a misinterpretation boom. It is all too easy to think: We endured all those lockdowns, vaccinated nearly everyone, and the disease is raging worse than ever? And then to think: They must not have worked. And then to seize on data that seem to validate this suspicion. Why, just look at the number of people getting infected who were fully vaccinated.
But the case for the COVID vaccine, like all vaccines, was never that it was 100 per cent effective: only that it is highly effective. As indeed it has proved. Prior to Omicron, a double-dose of the vaccine reduced your chances of being infected by more than 80 per cent; your chances of being hospitalized, by more than 95 per cent; your chance of dying, by more than 99 per cent.
Because only the infected can pass on the virus, the vaccines were helping to control the spread, as well as the severity, of the disease. By mid-December the rate of death from COVID – surely the most important indicator – had fallen below 0.5 per million population per day, an eighth of its pre-vaccine peak.
All that Omicron has changed, for the most part, is the infection rate. Without a third, or “booster” shot, the vaccine’s efficacy was reduced to 20 per cent – though with the booster, it was very nearly as effective as before. But it wasn’t only the vaccine’s immunity that Omicron was able to break through: “natural immunity,” the anti-vaxxer’s preferred defence, has proved just as porous.
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And unlike natural immunity – the immunity that arises from infection – the vaccine continues to provide protection against serious symptoms and death. Alas, no sooner had the first easy-out response – maybe the whole vaccine campaign was unnecessary – been debunked, than it was overtaken by a second: when the initial surge in Omicron cases was at first unaccompanied by increases in hospitalizations or deaths, people took it as evidence Omicron was nothing to worry about.
We keep falling into the trap that exponential growth lays for us. Whether Omicron itself is milder in its effects, or whether the comparatively low proportion of cases that require hospitalization is a consequence of the high vaccination rate, is immaterial in the end. With enough new cases, even with a lower hospitalization rate, the absolute number of hospitalizations will still rise, as will the number of patients in intensive care, and the number of deaths. And they will all rise as rapidly as the number of cases.
Which, with the usual lag, is precisely what has happened. Only a few days ago, some unwary commentators were still pointing to relatively low hospitalization numbers as evidence that authorities were overreacting. Since then they have skyrocketed. As of Dec. 27, there were fewer than 46 COVID patients in Canada’s hospitals per million population. By Jan. 5, nine days later, it had tripled, to 134. The numbers of those in intensive care increased over the same period, from 12.5 per million to 18.4; deaths, from 0.42 to 1.03. And it is only going to get worse from here: much worse, and very quickly, for some weeks to come.
Even so, there is resistance to the measures necessary to break the wave. It is forgotten how quickly case numbers fell after past lockdowns. That they never reached the levels predicted in advance of the lockdowns is taken as evidence, not that the lockdowns worked, but that they were unnecessary. More credibly, but only just, it is complained that lockdowns would not be necessary now had certain other measures been implemented before: had we rolled out booster shots more rapidly, tested more thoroughly, etc.
That may well be true. But it does not answer the question of what to do now. No doubt not every lockdown measure is well-advised, evidence-based or proportional: Quebec’s curfew comes to mind. But we are not going to get everyone booster shots or hand out tens of millions of rapid antigen tests in the next few days. Which I’m afraid is the time frame we are working with.
Even with the current lockdowns, such is Omicron’s momentum, the number of deaths per day is projected to more than triple, from roughly 30 a day at present to 94 a day in late February; if we were to give boosters to everyone who is now double-vaxxed, we might hold that to 88. The hospitalization rate is likewise projected to soar.
Neither are we about to radically reform our health care system – another favourite dodge of the “do-we-haftas” – any time soon. We would not have to impose such draconian measures to prevent our hospitals from being swamped, runs the argument, if there were not such a critical shortage of hospital capacity.
It is true that Canada has among the fewest intensive care beds, relative to population, of any developed country. Even before the pandemic, the system was arguably swamped, with long waiting lists for many surgeries and emergency clinics practising “hallway medicine.”
It does not follow, however, that any of this would be alleviated by spending gobs more money on health care – or by charging user fees, for that matter. Per capita health care spending in Canada, public and private, is already among the highest in the world. We don’t need to spend more: We need to spend better.
If the pandemic spurs that long-needed conversation, so much the better. But we shouldn’t kid ourselves. Even if we had twice as many ICU beds as we do, or three times, we would still be facing an emergency: Countries with famously well-resourced hospitals, like Germany or Switzerland, are having much the same troubles we are keeping up with the pandemic.
No system, no matter how well-funded, could easily manage the kind of astronomic increase in numbers we are currently witnessing. And no system could be sustained at a level of funding that would make it impervious to such surges. Some things can’t be avoided, or wished away. They just have to be endured.
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Andrew Coyne