Some time in the future, when all of this is finally over, there will be a postmortem effort on a scale this country has probably never before seen.
Provinces will assemble their own regional inquiries. There will be a massive, multi-pronged federal royal commission. Newly created bodies will undertake their own investigations, as will professional organizations representing essential emergency personnel. And each final report will culminate with a list of critical recommendations to implement in time for when the next novel virus makes its way to Canada.
It will take years of inquiry to fill in the details, but we know now – even in the midst of the current COVID-19 pandemic – what many of those reports will advise: A serious bolstering of public health budgets, perhaps with federal health transfers earmarked specifically for public health; careful tracking and maintenance of infectious-disease laboratories in order to keep up with surge demand during a pandemic; better integration and preservation of the National Emergency Stockpile System; an overhaul of long-term care homes to include space to quarantine infected residents, personal protective equipment for staff and systemic funding and regulatory changes such that personal support workers don’t need to work in multiple homes to earn a proper living. This is a non-exhaustive list.
The above recommendations should all sound familiar – they are, in fact, recycled from postmortem reports on Canada’s response to SARS nearly two decades ago. Indeed, the SARS Commission specifically warned of the dangers of unco-ordinated, underresourced public health agencies. The National Advisory Committee on SARS and Public Health emphasized the need for robust and dynamic emergency stockpiles. The Registered Nurses Association of Ontario documented the “extreme overreliance” on part-time and casual staff, which chronically plagues long-term care. We knew of all of these issues long before COVID-19 was first reported in China. But in the years since SARS, we’ve lost the impetus for actually putting these measures into practice.
The SARS Commission was prescient in anticipating the deleterious effect time could have on its recommendations. “As the memory of SARS fades,” it warned, “as budget pressures loom and when there is so much talk about change, it is important that governments, local, provincial and federal, are held to the talk: that talk becomes action and that necessary resource levels are maintained and are not permitted to decline.”
Canada did not heed that warning. We allowed stockpiles of equipment to shrink and expire, we watched provincial governments slash (or propose slashing) public health funding, and we left long-term care homes dangerously understaffed and undersupplied. In 2018, Ontario Premier Doug Ford clawed back paid sick days, which creates a disincentive for provincial workers to stay home when ill. The government of Quebec Premier François Legault shrugged off calls for a law to establish minimum standards of care in provincially run facilities.
These are all symptoms of what history professor Russell Jacoby called “social amnesia” in his 1975 book of the same name. It’s a form of collective forgetting – “memory driven out of mind by the social and economic dynamic of this society.”
As circumstances change, social priorities shift. We in Canada, for example, forget the pain and realities of war and thus allow our navy’s ships to fall apart and delay procurement initiatives. We forget about the struggles of living through an economic recession and thus rack up big spending deficits even during times of economic boom. We forget what it’s like to lose dozens of health care workers to a new respiratory disease and thus pledge to cut provincial funding for municipal public health agencies. It’s not until we’re hit with another war, or a recession, or outbreak of disease, that we remember the lessons we were supposed to have learned the last time around.
Compared with SARS, however, the impact of COVID-19 has been much more severe – both economically and in the number of those infected and dead – meaning the changes recommended in its aftermath could be adopted more swiftly and maintained much longer. But time will inevitably dull our collective recollection of the pain we’re experiencing now, and textbooks and discussion papers for future generations won’t be able to convey the visceral urgency we now understand only by living through a deadly pandemic. Indeed, if collective anxiety could translate through generations, anti-vaxxers wouldn’t exist 70 years after parents watched a polio epidemic take out their children.
The problem is not that we don’t – or won’t – know what to do after COVID-19 is finally under control. There will be plenty of commissions and task forces and auditor reports that will again lay out precisely that. The problem, rather, is one that’s more arcane: of human nature, of shifting perceptions and of the collective tendency to forget. That’s something even the most thorough royal commission won’t be able to fix.
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