Can I go for a walk?
That seemingly simple question underscores the complexity of finding the right public health response (and messaging) during a pandemic.
So let’s try answering.
Right now, most Canadians can go for a walk. Or a run. Or walk the dog. If – and this is an important “if” – they are not in isolation.
You can go for a walk if you have not been diagnosed with COVID-19, if you don’t have a recent history of travel outside the country, and if you don’t have symptoms that could be COVID-19 (whether you have been tested or not).
In the past week, most, but still not all, provinces and territories have declared states of emergency. The laws, regulations and recommendations vary in every jurisdiction, and that’s unnecessarily confusing.
Essentially, Canadians are being asked/ordered to avoid large gatherings (10-50 being the maximum), non-essential travel is banned, the operation of non-essential services is restricted, and even access to restaurant and food stores is curtailed (take-out only, maximum number of customers at a time, etc.).
Most important of all is a strong and universal recommendation to practice social distancing, the now ubiquitous phrase that means maintaining, wherever possible, a physical distance of 1-2 metres from other people.
Unlike large swatches of the U.S., unlike Italy, Canada is not under lockdown or quarantine.
People who are not sick and not recent travellers, can circulate freely. They can go for a walk.
But should they?
Ethically, is it right to go for a walk when we are being asked to keep our interactions to a bare minimum?
If we go outside and keep our distance from everyone else, what’s the harm? We’re all at risk of going a bit stir-crazy, cooped out in our homes.
But what if taking that walk requires you to first take an elevator? If a lot of people start taking walks, then significant congregations of people occur.
There is now good evidence that people with no obvious symptoms can transmit the virus. One study suggests that the seemingly healthy are, in fact, responsible for spread of coronavirus to most people who subsequently fall ill. Viruses are devious in that way.
As the number of infections rise, we need to behave as if we could all be infected, as if everyone around us could be infected.
Community spread of coronavirus is now a reality in many provinces. We could easily have 10 times the number of cases recorded in the official numbers. We have to stop pretending otherwise.
That’s why we’re seeing U.S. states like California and New York locking down.
The increasingly sophisticated modelling being done consistently sends the same message: If we’re going to have any hope of limiting the COVID-19 carnage, we have to hit hard and fast.
As the risks grow, our actions must accelerate.
At the same time, we have to ensure that the lockdown is not absolute. We need food, we need medicine, we need essential services, and we need the people who provide those services, from nurses to cashiers, to get around.
We also have to start thinking seriously, and preparing ourselves mentally, for how long this could go on, and how long we can tolerate a new normal.
Right now, we’re still in the bargaining phase: It’s okay to go for a walk, right? It’s okay to take the kids to the park, isn’t it?
Are these attempts to eke out a little bit more normal in these extraordinarily abnormal times just a bargain with the devil?
We can’t police the activities of every citizen. Ultimately, we all have to be socially responsible, to make personal sacrifices for the collective good.
The U.S. already has many more cases (20,000) than Italy did before it invoked a lockdown. Canada already has more cases (1,300) than Hubei did when it imposed a mass quarantine.
In each of those cases, delays in acting have translated into mass infections and numbing death tolls.
In Canada, we’re on the brink of being too late to prevent those dire outcomes.
It’s time to bring the hammer down, to move from polite entreaties to practice social distancing to firm orders to do so. This must be done with absolute clarity and a singular message.
It doesn’t feel like time for a casual walk, or casual talk, anymore.