Canada’s pandemic plan ought to make the next pandemic nonexistent

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We aren’t supposed to use the word postpandemic in Globe and Mail stories, and for good reason: Three-quarters of the world remains unvaccinated and Canada remains at risk for at least several more weeks.

But there is now a heady sense that the end is in sight here. Restrictions are lifting, mass vaccination is finally well organized and occurring at world-record speed, and the border may open soon. In a few months, we won’t want to look back.

We should, however – because for the most part, we blew it. A more-or-less conventional virus should not have taken four million lives, shut down the world economy and devastated countless livelihoods.

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This is the moment to talk about what to do next time. Luckily, we now have several huge databases, such as the Oxford COVID-19 Government Response Tracker, that track government actions alongside infection and death rates in scores of countries to see what had the most effect.

What really struck me, scanning the literature emerging from this data, was that the best policies – the ones we should be investing heavily in – are the ones that would keep pandemics from happening at all.

Restrictions and lockdowns weren’t needed

At face value, what those big-data studies show is roughly what we’ve known for a year: Infections and deaths are reduced most by closing workplaces and stopping indoor public and private events and gatherings, requiring masks indoors and limiting movement. (Schools are a more complicated matter.) At another level, it’s clear that what matters is timing: A study by the Centers for Disease Control found that simply implementing closings and gathering bans one week earlier “could have reduced mortality by 44 per cent.” Many countries that locked down in February, 2020, such as Vietnam, got the disease under control after that.

But our future plans should come from an even higher level – those places that didn’t need widespread restrictions or lockdowns in 2020-21, or only briefly during local flare-ups, because the pandemic never really hit them. Australians and New Zealanders generally lived the same lives they did in 2019 (until recently, when new variants provoked temporary restrictions).

There’s one reason: Both countries imposed mandatory hotel quarantine for everyone entering, citizen or otherwise. Rather than tens of thousands of deaths, they’ve experienced only a handful since fall, 2020, almost all of them within quarantine hotels, which is as it should be. Quarantine causes the pandemic to play out in containment.

But, some Canadians will ask, isn’t that because they’re island nations, without a land border? Those Canadians don’t likely live in the four Atlantic provinces, where work, school, social life and entertainment went on largely as usual in 2020-21 because their premiers agreed to impose a strictly enforced mandatory quarantine system early. Commercial border movement isn’t hard to isolate without interrupting commerce. In a pandemic, all nations are island nations.

Canada should have a universal hotel quarantine plan ready to implement, with the a priori agreement of all major parties and levels of government, from day zero of any future pandemic. It should be triggered automatically by an early warning system of the sort that Canada cancelled in 2019. Universal quarantine is the only policy that is absolutely proven to keep the virus out of a country and allow life to continue as normal. It’s what we deserved.

Vaccination can happen before the pandemic strikes

Both quarantines and restrictions could also be rendered unnecessary if we’re already immune to the disease. That’s how we do it with the flu, after all: Scientists identify emerging pathogens before they spread, and we get vaccines for them in the fall, so many never become epidemic.

The development speed of the COVID-19 vaccine was described as a heroic accomplishment. In fact, it could have happened a year earlier, before the pandemic took place – possibly even before the specific virus was isolated.

As health scholars Sarah Wetter, Lawrence Gostin and Eric Friedman noted recently, we have mRNA vaccine platforms that allow near-instant manufacture of vaccines against viruses that have just been identified, and even some that have not yet been. Scientists say we could have had COVID-19 vaccines in arms in February, 2020, had there been better planning and investment.

And we’re close to having “pan vaccines,” which protect against entire categories of existing and not-yet-existent viruses – potentially against, for example, all possible coronaviruses. A fully universal vaccine may still be decades away, but we could have broad-sweep advance protection much sooner if countries could agree to drop national interest and invest billions each in a shared initiative.

Canada needs a big, detailed plan, and big investments shared with other countries, to allow us to act fast next time a microscopic threat emerges – not just to minimize harm, but to prevent it from becoming a pandemic at all.

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