A recumbent cyclist pauses at a stop light along O'Connor Street in Ottawa, on July 19, 2020, in the midst of the COVID-19 pandemic.Justin Tang/The Canadian Press
Livio Di Matteo is a professor of economics at Lakehead University and senior fellow at the Fraser Institute.
More than 167 million people have reported COVID-19 cases worldwide, and more than 3.4 million have died. Given the spread of new variants and varying vaccination rates around the world, the effects of the pandemic will be with us for some time to come. And in this grim toll, Canada has endured more than 1.3 million cases and more than 25,000 deaths.
Among advanced countries, this seems like a below-average but not disastrous performance. In 2020, as mentioned in a new study published by the Fraser Institute, COVID-19 cases for every million ranged from a high of 87,000 (Czech Republic) to a low of seven (Taiwan), with Canada (approximately 19,000) ranked 24th out of 35 advanced countries. Deaths for every million ranged from a high of almost 1,800 (Belgium) to 0.3 (Taiwan), with Canada in 22nd place (approximately 500 deaths for every million).
However, on a crucial measure – the “case fatality rate,” or the total deaths from COVID-19 as a percentage of total COVID-19 cases – Canada put forth the seventh-worst performance in the developed world, owing primarily to the impact on residents of long-term care. In 2020, 11 per cent of Canada’s COVID-19 cases, and more than 70 per cent of COVID-19 deaths, were in long-term care facilities.
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According to the Canadian Institute for Health Information, while Canada’s overall COVID-19 mortality rate was relatively low compared with rates in other Organization for Economic Co-operation and Development countries, we had the highest proportion of LTC deaths. If we’ve learned anything from COVID-19, it’s that we must do a much better job with long-term care here at home.
Unfortunately, lessons provided are not always lessons learned. Crucially, the numbers show Canada failed to learn from its most recent opportunity for education: the SARS outbreak.
Between 2002 and 2004, about 30 countries reported SARS cases, with only eight countries reporting more than 10 cases and only five (China, Hong Kong, Taiwan, Singapore and Canada) reporting more than 100 cases. Fast forward to 2020, and these five countries combined reported about 18,000 fewer COVID-19 cases for every million compared with countries that did not experience SARS. But while Hong Kong, Singapore, China and Taiwan saw their 2020 COVID-19 deaths-per-million numbers range from 22 to 0.3, Canada reported nearly 500 deaths for every million. In this key five-country group, Canada was a significant outlier.
Post-SARS, governments in Canada studied and planned for future pandemics and increased spending on public-health measures. Yet successive federal governments produced conditions that left Canada unprepared for COVID-19, with the Trudeau government seemingly quietly deactivating the country’s pandemic early warning system in 2019, failing to maintain stockpiles of personal protective equipment and moving slowly once the pandemic began. Taiwan, in contrast, established a National Command Centre in 2004, which helped the country co-ordinate and map out its current and significantly more successful pandemic response.
Other countries also showed high rates of testing remain an important factor, with each additional 100,000 tests for every million associated with 21 fewer COVID-19 deaths for every million. Last year, however, Canada ranked 26th out of 35 advanced economies for COVID-19 tests for every million.
Another important factor was the number of hospital beds for every 1,000, with each additional bed associated with 31.5 fewer COVID-19 deaths for every million. Among 35 advanced countries, hospital beds for every 1,000 ranged from 13.1 (Japan) to 2.2 (Sweden). Canada was near the bottom, at 2.5.
Key deficiencies in Canada’s preparation and response capability even after the harsh lessons of SARS, combined with low rates of testing, low numbers of hospital beds and an inadequately prepared and protected long-term care sector, have led to a relatively poor pandemic response, particularly on certain measures of mortality.
As a result, federal and provincial governments were forced to rely on lockdowns and other stringent measures, and while they were effective during the first wave, they were less successful as Canadians grew tired and confused with the prolonged restrictions and shifting rules. And it was these restrictions imposed by government, not the pandemic’s death rates, that caused the economic disruption that will continue until a sufficient proportion of the population has been vaccinated.
In light of the suffering we’ve witnessed during this crisis across the country, let’s hope we actually learn more this time around.
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