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Dr. Robert Strang, Nova Scotia's chief medical officer of health, arrives for a press conference in Halifax on March 6, 2020.

Andrew Vaughan/The Canadian Press

Traditionally in Canada there is a health gradient that goes from north to east to west.

Health outcomes – everything from traumatic injuries to rates of chronic illness to life expectancy – are the worst in the north, get slightly better in the Atlantic provinces, and gradually improve as you move across Quebec, Ontario, the Prairies and the Rockies before arriving at the health pole star of British Columbia.

With COVID-19, the pattern has been different.

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The three territories and the four Atlantic provinces have put the more wealthy and populous provinces to shame with their strict, no-nonsense pandemic-control measures.

This demonstrates, more than anything, that political will and public buy-in matter more than resources in controlling the spread of the coronavirus.

Is my area going back into COVID-19 lockdown? A guide to restrictions across Canada

Overall, the pandemic has hit hardest by every calculable measure – deaths, hospitalizations, cases – in Quebec.

This can be explained, in part, by bad luck. The virus hit Quebec hard in March, 2020, because of an early spring break that resulted in travellers bringing the virus back; this allowed it to take root. The province reacted slowly and has never really fully recovered. This despite having enacted the toughest measures in the country in recent months, including lengthy curfews.

Ontario, arguably, has been hardest hit politically. The criticism of Premier Doug Ford’s handling of the pandemic has been loud and relentless. This can be explained, at least in part, by the concentration of news media in Canada’s most populous province – though the narrative has been helped immensely by the province’s abysmal communication. Ontario also has an enthusiastic cadre of outspoken health experts.

Given the significant news coverage, many might be surprised to learn that Ontario’s pandemic performance is actually slightly better than average, at least in terms of cases and deaths per capita. Even now, with daily dire reports of hospitals on the brink, Ontario does not have the worst COVID-19 hospitalization rate. That dubious honour belongs to Saskatchewan, with Manitoba and Alberta not far behind. But for better or worse, the criticism of politicians and public officials is more muted in the rest of the country.

While we’re doling out prizes for poor performance, it should be noted that Manitoba also has the worst per capita death rate after Quebec, and Alberta takes second-place “honours” (again, after Quebec) in terms of cumulative cases per capita.

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The poor showing of the Western provinces is doubly troubling because they got off relatively lightly in the first wave and were hammered by the far more predictable and preventable second wave.

The one province that has not been mentioned so far is British Columbia. That’s because the Pacific province has the best outcomes in every category – cases, hospitalizations, deaths – among all the provinces west of New Brunswick. B.C. has “charted a different course,” to quote Provincial Health Officer Dr. Bonnie Henry.

If you recall your ancient history (ancient, in pandemic time, meaning January, 2020), B.C. had the first COVID-19 death in Canada, at the Lynn Valley Care Centre in North Vancouver. The province acted swiftly, largely avoiding the carnage in nursing homes that soon occurred in Quebec and Ontario. Tragically, however, B.C. was as complacent as other provinces during the second wave, and long-term-care deaths soared.

One of the fascinating things about B.C.’s pandemic response is that the province has largely avoided the frustrating cycle of lockdowns and reopenings, and it has done so primarily by doing the bare minimum.

Until recently, B.C. had far fewer restrictions than any other jurisdiction in Canada. (It also has a handy foil next door, with neighbouring Alberta always seeming to do far worse while generating lots of political controversy, to boot.)

More than anything else, B.C. has managed its pandemic messaging masterfully. It has done so despite having the worst data and the least transparency – and despite undertaking some dubious decisions, including waiting too long to close ski hills (this has allowed case numbers to explode recently).

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Dr. Henry is clearly in charge, at least on the public stage, with the province’s politicians in the background. That is a stark contrast to Ontario, where Mr. Ford takes centre stage while its Chief Medical Officer, Dr. David Williams, stumbles and bumbles behind him.

The question now is whether Dr. Henry’s mantra of “be kind, be calm, be safe” can still work, or whether B.C.’s largely laissez-faire approach will catch up with it – and whether, perhaps just as importantly when it comes to the optics, the ineptitude of other provinces will make it all look not so bad, relatively speaking.

Prime Minister Justin Trudeau says Ottawa is working with provinces to get Canadians vaccinated as quickly as possible against COVID-19. The Canadian Press

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