Amol Verma, Arthur Slutsky, and Fahad Razak are physicians and professors at St. Michael’s Hospital, Unity Health Toronto and at the University of Toronto. Drs. Slutsky and Razak are members of the Ontario COVID-19 Science Advisory Table; Dr. Razak and Dr. Verma are Principal Investigators of the COVID-19 Hospital Analytics Laboratory.
Canada has arrived at a crossroads in the COVID-19 pandemic.
Some parts of the country are facing dire situations – most prominently Alberta, Saskatchewan and New Brunswick – where a singular focus on controlling COVID-19 rates is essential to prevent further suffering and mitigate health system collapse. However, across much of the country, parents have sent their children back to school and white-collar workers are slowly returning to their offices. Of course, the virus remains a threat, but life is slowly regaining a semblance of normalcy and the recovery process has begun.
In this context, governments need to make increasingly nuanced policy decisions to control the pandemic while maintaining the economy, schools and other parts of life. And yet, there has been an overly narrow focus in the kinds of information that governments regularly report and what media outlets tend to cover around COVID-19. Rates of testing, case counts, deaths, hospitalizations, and vaccination rates have been the central data points, and they are clearly very important and capture the direct medical effects of the virus – but they do not effectively describe the many ways that the pandemic and public health measures affect society.
We can easily report a given province’s COVID-19 case counts, for instance, but it is much harder to find real-time numbers for small business closures, delayed cancer surgeries, deaths from overdoses, housing evictions, or school absences. As much of the country is likely set to enter an endemic phase of viral spread, the effectiveness of mitigation strategies cannot truly be understood without such information on the economy, schools, or individual well-being.
Governments should invest in obtaining, modelling and reporting this broader data with the same clarity and focus they have applied to COVID-19 medical data. This will help people understand the societal effects of continued spread and of the measures being taken to control it. Governments need to appeal to many different interests as they call on people to make individual sacrifices in the service of the common good, and broader considerations and information can help produce this buy-in and make more confident decisions.
For example, government policy choices have commonly been framed as a trade-off between public health restriction and economic interests. Although this may have been true in the short run, it now appears likely that more stringent public health measures led to swifter and stronger economic recovery. It is worth noting, in fact, that Canada – which enacted strict lockdown measures – has now reached pre-pandemic levels of employment, even as other countries remain mired in economic turmoil. Justifying public health interventions with a broader range of data may avoid some of the backlash and polarization that have been a hallmark of the pandemic.
Broader data reporting also gives governments and societies an opportunity to celebrate their successes, including lower crime rates or sustained school openings. Celebrating such wins is important for maintaining public morale.
To be clear, we are not arguing against public health interventions – in fact, we are arguing for exactly the opposite. We believe that governments were right to minimize harm from the pandemic. But what we are calling for, as we move forward, are broader and more holistic kinds of data to inform, justify and clearly communicate policy choices.
We understand that it is not easy to provide timely, detailed data across multiple societal domains. Fortunately, as we described recently in the Canadian Medical Association Journal, governments can build on the efforts of academics and think tanks to acquire this information. For example, the U.S.-based Opportunity Insights Economic Tracker uses real-time anonymized data from private companies to describe consumer spending, small business revenue, employment, and student progress. That information has generated striking insights, including the finding that while the pandemic-induced recession has largely ended for high-wage American workers, employment for low-wage Americans has not rebounded. That has led to a practical policy conclusion: “the only way to drive economic recovery is to invest in public health efforts that will restore consumer confidence and spending.” Such insights would be a major asset for policy-making here in Canada, too.
The pandemic has shown us the value of timely data. We must build on this success and widen our lens, to harness more data for superior decision-making. If we act now, we could make better-informed policy and a more engaged and informed citizenry a productive legacy of this terrible time.
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