Lessons learned from the pandemic about health care

When we pull together, we can quickly achieve results that have escaped us in the past.

image: Hartford Healthcare

Some liken to being at war but I prefer to compare the pandemic response to what happened when we created universal health care.

Governments have been reluctant to implement the universal coverage of drugs in the past, but in short order we have vaccines freely available for all Canadians.

It’s that easy. A universal pharmacare program could happen, too. All it takes is the will to carry it out.

Canada has the dubious distinction of being the only country in the world with universal health care that doesn’t include prescription drugs.

Canada has been stuck in a time warp since the inception of health care. When Tommy Douglas envisioned a healthcare system in 1947, it included hospitals and then later, doctor’s services.

Other countries have moved on. New Zealand’s publicly funded system goes beyond hospital and physician care to include long-term care, mental health, physical therapy and prescription drugs.

While we like to boast of our healthcare system compared to our neighbours to the south, in reality ours is just good enough. Canada is stuck in “paradigm freeze” — good enough to prevent any major change or improvement.

The pandemic can shake us from our stupor and awaken us to the fact that a universal pharmacy program is cheaper for all, not just in the bargaining power of negotiating drug prices but in reduced healthcare costs resulting from a healthier population.

Another lesson learned was how rapid we can achieve, essentially, a basic universal wage. The Canada Emergency Response Benefit (CERB) was distributed virtually overnight.

CERB has been replaced with other programs but with the political will to make it happen, Canada could have a basic universal wage.

A reduction in poverty through a basic income could improve health. The connection is deep, say Drs. Nadine Caron and Danielle Martin:

“But, perhaps surprisingly, the experiment [CERB] that may have had the biggest impact on health during COVID-19 didn’t take place in the healthcare system at all.” (The Walrus, Jan/Feb, 2021)

The connection between finances and health is well studied. Between 1993 and 2014 in Ontario, for example, residents of the poorest areas were more than twice as likely to die from a preventable cause as those living in the wealthier neighbourhoods.

Another lesson learned was from the fewer diagnostics done during the pandemic.

On the negative side, cancelled tests meant that diseases went undetected. The B.C. Cancer agency estimates that 250 British Columbians unknowingly had silent cancers go undiagnosed as their screening mammograms, colonoscopies, and pap smears were cancelled in just the first six weeks of the pandemic.

On the positive side, many tests routinely done may be unnecessary. If all those tests are so important, why aren’t they done uniformly across Canada? Chris Simpson, a cardiologist and former president of the Canadian Medical Association, wonders:

“Why do patients in one region get these tests and procedures at higher rates than other regions?”

The simple answer may be that, like prescriptions, doctors like to order tests so as to be seen to be doing something towards patient care. All those tests may not be the best use of resources.

Canadians can be proud for pulling together during this crisis. Let’s not forget what we can accomplish.

The young have sacrificed much during the pandemic with little to show

Young Canadians have been blamed for being irresponsible during the pandemic for going to parties and bars. But there’s more hype than truth to these accusations. The deadly virus has been spread by people of all walks of life.

BLM demonstration Kamloops. Image: CFJC Today

Young people are sacrificing the opportunities of a lifetime. This is a time to build professional networks for future careers. Relationships have been delayed at a time that they are looking for lifetime partners. Families are being put off for better times.

As an older person, the sacrifices I make are minimal –stay home and watch Netflix. Sure, I miss going to shows, bars and restaurants but these can hardly be characterized as sacrifices compared to what young people endure.

Government response has been geared to protecting the assets of older people, particularly wealthy old people. When stocks crashed in the self-induced pandemic recession, central banks pumped money into markets to preserve share worth and property values.

Economic relief is geared toward protecting the wealth and income of the top 10 per cent in society -those with homes, accumulated wealth and a defined-benefit pension- not for young people.

Young people have been hard hit with job losses and increased exposure to the virus. They’re more likely to live in shared accommodation and work in jobs that require a high degree of face-to-face contact. They are more likely to rely on public transit. And when they work in office buildings, it’s in relatively cramped conditions.

But what is clear is that if governments are determined to “return to normal,” the bulk of new infections will likely occur among young people for the simple reason that they inevitably engage in more social interaction than older people.

Despite receiving an unfair share of the blame for spreading COVID-19, young people have received little credit for leading protests against injustice.

Many young people are deeply idealistic, calling for such things as democracy, racial equality, climate action, human rights and justice in policing.

In Kamloops last summer, young people organized a protest in support of the Black Lives Matter movement. They called it BIPOC (Black, Indigenous and People of Colour) to reflect the overall injustice of racism.

The Tiny House Warriors in Kamloops, led by Indigenous youth, have protested the building of the Trans Mountain pipeline on unceded Secwepemc Territory.

The Idle No More movement, founded in 2012 by Indigenous youth, was in reaction to the Harper government’s removal of protections for forests and waterways in Bill C-45.

“Let’s be brutally frank here,” says John Rapley, political economist at the University of Cambridge, “As a disproportionate number of elderly people died, young people might actually face improved economic prospects.”

Young people have the most to gain when this pandemic sweeps the globe. Older people are more likely to die from COVID-19, which could improve the economic prospects of the young; fewer people drawing from pension plans, more houses on the market which would drop the price.

Young people have borne, and continue to bear, the brunt of isolated social interactions. They lead movements against racism, brutality and colonialism with little appreciation for their efforts.

Shared delusions in Lee Creek and the USA

It’s amazing when two or more people share the same delusion. You have to wonder how that’s possible.

image: The Victor Voice

Look at what happened in Lee Creek. Police were called to the small community on Shuswap Lake where they found two men barricaded inside a house, firing guns at imaginary creatures. The men were relieved when the police arrived because they were surrounded by hundreds of wild animals. They told their detailed observations with police:

“They described in detail having seen cougars kill deer and moose in the front yard,” said Sgt. Barry Kennedy in a news release. “They reported seeing the cougars drag the dead deer and moose up into the tree canopy, where the dead animals were purportedly still hanging. They also believed there was a pile of dead bears in the backyard (CFJC Today, Nov. 25, 2020)”

Well, you might say, we all share a reality of the world we consider to be true. It’s the only way societies can function. Who’s to say what reality is true and anther delusional?

That’s the beauty of the scientific method: investigate and gather evidence.

Police found no piles of bears and concluded that the two men were suffering from a “health crisis.” Their shared reality was a delusion.

In the U.S., and Canada to a lesser extent, millions of people share the perception that the COIVD-19 pandemic is a political ploy. Jodi Doering, an emergency room nurse in South Dakota, told CNN of patients who refused to believe that they were dying of COVID-19. They preferred to believe that it was lung cancer or pneumonia because COVID-19 didn’t exist.

“Their last dying words are, ‘This can’t be happening. It’s not real.’ And when they should be… Facetiming their families, they’re filled with anger and hatred,” said Doering.

Why would someone die of COVID-19 believing that it doesn’t exist? Well, their president told them so. The Outgoing President (OGP) said that after the election over, the virus would simply disappear. You see, the pandemic is just an election ploy by the Democrats.

Where is the evidence to support that claim?

If the RCMP were called to the emergency room in South Dakota, they would be justified in concluding that the COVID-19 deniers were suffering from a “health crisis.”

It’s all part of parallel information machine. In one of the parallel tracks is the news covered by reporters whose job it is to dig up the facts and investigate claims. The alternative track to the news is the opposite; I’ll call it “swen,” news spelled backwards. What would be facts in the news is conjecture in the swen. What is an investigation in the news is a conspiracy in the swen.

Swen has a magical quality to it. You can bring truths into existence just by saying they are so.

Look at what happened when a supporter of QAnon tweeted that Wayfair Furniture was involved in a sex-trafficking ring involving children. Bingo. It was true. Believed by millions.  It was even circulating in Kamloops social media circles.

QAnon, itself, became swen after a mysterious one or more people said it was true.

What the QAnon believers of the Wayfair swen is a fiction within a fantasy. The fantasy is that QAnon is an underground network of Democrat pedophiles. The fiction is that Wayfair is selling children, not furniture.

Like parallel lines, these parallel realities will never meet. One of the “gifts” of the internet is that millions of swen believers live in a delusion totally foreign to news followers.

There aren’t enough RCMP to round them up.

COVID-19 is more costly to humanity than climate-change

The COVID-19 pandemic has changed the way I regard climate change. Don’t get me wrong: climate change is real and it’s man-made. But it not the “the greatest threat to humanity” that I once characterized it.

image: Dialogue of Civilizations Research Institute

The greatest threats to humanity are the pandemics caused by our violation of the natural world of animals. As we recklessly tear nature apart, we reap the whirlwind of its viral bounty.

World leaders have exploited our fears of climate change. The World Health Organization famously called climate change the “greatest threat to global health in the 21st century.” Leaders of the richest nations gathered in Davos this January and declared that climate accounted for all the long-term biggest risks to the world.

Persistent scare stories have convinced us that the climatic end-of the-world is nigh. One survey of 28 countries shows that almost half of all people believe climate change will likely lead to the extinction of the human race.

The world’s poor don’t see it that way -they rank climate change quite differently. When the UN asked 10 million people, mostly those in the majority world who are poor, what they regarded as the world’s top priorities, they emphasized better education, health care, jobs, government and nutrition. Climate change ranked 16th out of 16 priorities – right after phone and internet access.

Bjorn Leonhard, President of the Copenhagen Consensus and author of False Alarm: How Climate Change Panic Costs Us Trillions, Hurts the Poor, and Fails to Fix the Planet, says:

“Global warming is a real challenge and a problem we need to tackle. But the alarmism makes it difficult for us to think smartly about climate solutions and it diverts our attention away from the many other important global issues (Globe and Mail, July 19, 2020).”

Sea level rise is very real problem but it’s often portrayed in apocalyptic terms. We are told by the UN climate change panel that 187 million people will be displaced. Bloomberg News declared that coastal cities such as Miami may “drown in 80 years.”

But that number assumes that we do nothing in the meantime. In fact, people don’t just sit around while the water laps at their feet. The same UN climate change panel shows that with adaptation, such as protection with dikes or seawalls, the number of people in the world who have to move by the end of the century is just 305,000. For comparison, four times that number of immigrants now live in B.C. according to the 2016 census. B.C. could accommodate all the world’s water refugees.

The economic effects of climate change are serious but not fatal. The UN Intergovernmental Panel on Climate Change found that the economic effect of climate change would reduce the average person’s income in the 2070s by 0.2 per cent to 2 per cent. The reduction means that we will “only” be 356 per cent richer today instead of 363 per cent richer without the impact of climate change. That’s a sombre finding but not as bad as the economic fallout of the COVID-19 pandemic from which we may never fully recover.

The impact of climate change is real but it pales in the light of the economic impact of this global pandemic.

 

 

This is the way the pandemic ends

This is the way the pandemic ends. Not with a bang but a whimper.*

The novel coronavirus, SARS-CoV2, is sweeping the globe like wildfire killing hundreds of thousands in its wake. But its months are numbered. In a year or so, it will become part of the suite of viruses that regularly infect us –it will become endemic.

image: pingtree.com

It will be demoted to a common coronavirus, one of the seven known human coronaviruses. Four are part of the regular group that cause one-third of common colds.

But this virus will be remembered as being distinct from its older brother, SARS-CoV which caused the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003. This new coronavirus is sneaky.

The older coronavirus was conspicuously clumsy. Infected people became infectious after they became sick. They were flagged with the disease before they passed it on. Infected people with serious problems breathing and a fever showed up at hospitals where the disease was largely contained. Epidemiologist Benjamin Cowling of the University of Hong Kong says:

“Most patients with SARS were not that contagious until maybe a week after symptoms appeared (Scientific American, June, 2020).”

When sick people are not contagious, they can be quarantined before spreading the disease. Containment of SARS worked so well that only 8,098 cases were reported globally with 774 deaths, mostly in Toronto and Hong Kong.

SARS-CoV’s evil younger brother, this one that causes COVID-19, uses stealth. Infected people spread the disease before they show symptoms. You can be asymptomatic and feeling fine, all the while shedding the deadly virus. No warning signal until after the damage is done.

Hospitals are particularly vulnerable. When I went to the emergency section of the Royal Inland Hospital in Kamloops to get stitched up, I was intercepted at the entrance and asked if I had any of the COVID-19 symptoms. I didn’t but I could have been infected and spreading the virus. They took a chance on treating me, for which I’m thankful.

Political leaders can play a part, or not. Trump twiddles as the pandemic wildfires rage across the land of the free. Beachgoers merrily flock together in Florida and California. As protesters defend their constitutional rights to carry guns and not to wear masks, the novel coronavirus revels in the merriment.

While SARS-CoV-2 enjoys its killer notoriety now, soon it will be just another garden-variety nuisance.

The most famous example of a virus’s fall from infamy is the Spanish flu pandemic caused by the H1N1 virus from 1918 to 1919. In over two years and three waves of assault, the pandemic infected 500 million and killed nearly 100 million.

Health officials didn’t have the control measures we have today, simple measures like school closures and physical isolation. It ended only when enough people survived the pandemic with immunity.

Governments have demonstrated their worth during the pandemic, or not. Canada is doing a good job but our neighbours to the south, not so much.

Sarah Cobey, epidemiologist at the University of Chicago, says: “The question of how the pandemic plays out is at least 50 percent social and political.”

The other 50 percent comes from science in the development of a vaccine. Only then will CoV-2 be completely vanquished.

Until, vigilance is the adage. CoV-2 will sneak up on you when you least expect it.

* My apologies to T. S. Eliot, author of the poem “The Hollow Men” (1925).

Should B.C. bubble-up with neighbours?

Canada’s four Atlantic Provinces have agreed to open their borders to each other on July 3, creating a regional pandemic bubble. What are the opportunities for B.C.?

image: Britannica

The Atlantic bubble means that travellers within the region will not be required to self-isolate after crossing the borders. Travellers will have show proof of residency with a driver’s licence or health card.

As we know from creating bubble families, picking who you want to bubble up with is tricky -a bit like asking someone to dance. Who is desirable? Are they available? Do they practice safe social intercourse?

For the Atlantic Provinces, it was easy. Not only are they attractive because they form a natural geographic area but also there are no active COVID-19 cases, with the exception of New Brunswick and that was caused by a doctor who was infected upon returning from Quebec. They form a natural regional bubble that’s desirable, available, and safe.

Countries can bubble up with neighbours as well. While not quite bubbles, the European Union has loosened border restrictions this week to 15 countries including Canada but not the U.S. Russia, or Brazil. The loosening includes countries that have controlled the spread of COVID-19.

But while some countries are desirable, they are not available. New Zealand makes an appealing partner because they have largely contained the virus. But they want nothing to do with bubbling after three new travel-related cases were reported.

Canada’s travel and tourism industries want to bring more countries to the dance floor. In an open letter to Prime Minister Trudeau in the Globe and Mail, they say 14-day quarantines and travel restrictions are “no longer necessary” and are “out of step with other countries across the globe,”

Trudeau objects, saying that lifting travel restrictions now “would lead to a resurgence that might well force us to go back into lockdown.”

Epidemiologists agree with Trudeau. Lauren Lapointe-Shaw, general internist and clinical epidemiologist says: “Travel is the one segment of the economy that probably has the greatest potential to derail our ability to stay out of lockdown.”

The problem is not just being in a metal tube hurtling through the sky with dozens of other passengers, it’s the dangers that await you on landing. “When people travel, they don’t travel to stay indoors with their close travel companion at their arrival destination,” Dr. Lapointe-Shaw said. “Travel does have an outsized effect on the ability of outbreaks to grow quickly.”

When B.C. is stares across the dance floor at potential partners to bubble with, there are Alberta and Washington State.

B.C.’s relations with Alberta are a bit prickly. Last month, travelers with Alberta plates have received nasty notes and had tires slashed. One Alberta traveler had a note attached to his windshield reading: “F-ck off back to Alberta! Supposed to be not doing non-essential travel.” Soon after, he also noticed a large scratch on the side of his car.

The love with Alberta just isn’t there.

Washington State forms a natural geographic area with B.C. It’s part of Cascadia, a loose association of bioregions along the West Coast. While appealing, Washington is off limits as the U.S. spirals into an every-growing deadly pandemic.

It looks like B.C. will have to sit out this dance.

Money spent on public transit could be better spent elsewhere

Equality, not density is responsible for the spread of COVID-19 says UBC Professor of Architecture Patrick Condon.

image: Humantransit.org

“The issue of transfer of this disease doesn’t seem to be density itself, it tends to be the inequalities that are associated with living in a major metropolitan area … both in terms of the jobs that [poorer] people are working and the additional need they have to use public transit to get around,” he told CBC Radio’s Spark (April 24, 2020).

In New York, for example, the hardest-hit neighbourhoods were not wealthy Manhattan but poorer boroughs like Queens, Brooklyn and the Bronx. In Canada, condo buildings in central Toronto or Vancouver aren’t COVID-19 hotspots because the people who occupy these higher-end rentals have the “luxury of jobs that can be done from home,” says Professor Condon.

Others in the service industry such as grocery store workers aren’t so lucky. They have to work in public spaces and need to take public transit to get to work.

Commute times have increased over the last decades as affordable housing is pushed further away from where people work. Longer commute times increases the exposure to pathogens.

Environmentalists, such as David Suzuki, have indentified some solutions to urban planning but miss one important one. Suzuki says:

“During the COVID-19 pandemic, cities worldwide have been repurposing streets to create more room for walking and cycling. In some, temporary measures to help people maintain physical distancing, like lower speed limits and limited car access, are providing impetus for permanent changes that prioritize healthy mobility choices over cars (armchairmayor.ca, June 17, 2020).”

What Suzuki misses is the fact that most people don’t live where they work. Walking and bicycling is great for getting around near where you live but many workers live in distant suburbs and rely on public transit.

However, the use of public transit has declined during the pandemic and its future is in doubt because people have found other ways to get to work.

Money spent on public transit could be better spent elsewhere, like affordable housing near where people work.

Public transit has long been promoted as a reasonable alternative to cars. However, that’s only true when busses are full. Mass transit vehicles use up roughly the same energy whether they are full or empty, and for much of the time, they’re more empty than full.

“Subsidized transit is not sustainable by definition,” says Wendell Cox, a transport policy consultant in St. Louis, and former L.A. County Transportation commissioner. “The potential of public transit has been so overblown it’s almost scandalous.”

Professor Condon’s alternative to public transit is to move people closer to work rather than have them commute long distances. Once workers don’t have to sit in cars and public transit, they can get around in the ideal communities that Suzuki imagines.

Condon agrees with Suzuki on one point: city streets take up a lot a space and would be better used purposes suitable to humans.

Post-pandemic urban planning that has people living closer to work meets the goals of reduced commute times, less pollution, and the avoidance of future pathogens.

 

Pandemic exposes failings of long-term care facilities in B.C.

In 2002, the BC Liberals had a grand plan to provide seniors with home-like settings. Added to that, they promised that the new residences would cost the government about half as much. Who wouldn’t want that?

image: WebStockReview

Home-like residences would be financed through public-private partnerships (P3s). Reduced costs to the government would result by attracting private-sector investors to finance new residences.

However, the plan hasn’t worked out that well.

Sure, the government reduced their costs but it was by shutting down existing facilities. Between 2001 and 2004, the government closed 26 long-term care facilities, resulting in the loss of 2,529 long-term care beds according to a report prepared for the Canadian Centre for Policy Alternatives called Assisted Living in British Columbia, Trends in access, affordability and ownership.

The fallout of the grand experiment is fewer, unaffordable housing units.

According to Statistics Canada and the Canada Mortgage and Housing Corporation (CMHC), the cost of Private-Pay assisted living exceeds the financial resources of seniors with average or low income.

Affordable housing is defined as rent less than 30 per cent of income. While wealthy B.C. senior couples can almost afford rent according to that definition (39 per cent), seniors living alone in a bachelor suite require over 80 per cent of their income for rent, which is clearly unaffordable. At rents that high, seniors will be doing without basic sundries, medications, transportation, and entertainment.

Seniors who can’t find lower cost Publicly Subsidized residences are turning to Private-Pay residences as a last resort, even though they can’t really afford them.

And while the number of Private-Pay and Publicly Subsidized units has increased marginally, it hasn’t kept up with demand. The net new Private-Pay units have only increased by 1,130 in all of B.C. from 2010 to 2017. In the Interior Health region, the net new Private-Pay units only increased by 243.

The number of Publicly Subsidized assisted living units added in the same period is even more dismal -only by 105 for all of B.C. and by 26 for the Interior Health region.

The labels “Private-Pay” and “Publicly Subsidized” are misleading.

Private-Pay suggests that these residences are built independently and rented at market prices, like a hotel. However, the government pays the operator of these facilities a daily resident rate and BC Housing, a crown corporation, pays for housing costs.

Publicly Subsidized is equally misleading. It suggests that the residences are owned and operated by the government. They are not: 63 per cent are owned by a non-profit organization, 33 per cent are owned by a for-profit business, and only 4 per cent are owned by a public health authority. Unlike Private-Pay facilities, renters are subsidized according to their ability to pay.

As the pandemic unfolded, it became apparent that some Private-Pay residences did not meet the legislated standards of care for residents. As a result, health authorities seized control of a number of residences owned by Retirement Concepts, British Columbia’s largest chain of for-profit care homes.

Long-term care facilities in B.C. didn’t meet the needs of most seniors before the COVID-19 pandemic and now the outbreak has focussed a spotlight on those failings.

More Publicly Subsidized residences need to be financed by BC Housing and operated by non-profits and for-profit businesses. The housing may not be grand but when well-designed, they can be comfortable, affordable, safe, and profitable.

Bubble families emerge from pandemic

Provinces are allowing the expansion of family units to include friends and family. The selection of who’s in and who is out is tricky.

image: Money Crashers

B.C.’s provincial health officer, Dr. Bonnie Henry, said last week: “I believe that we are at a point where we can increase our social contact, and we can have more people in our close circle of family and friends.”

Singles can pair off with another single or with a couple and socialize exclusively with them.

Families can also pair off with other families. But it has to be done carefully. As soon as you add others to your circle, you add all the people which they are connected to which amplifies the risk.

Before you extend your bubble family, sometimes called a cohort family, you need to check with them to ensure that their degree of virus avoidance matches yours. It would be a mistake to extend your circle to a family just because they’re “cool” as Professor Lucia O’Sullivan found out.

O’Sullivan wasted no time inviting her “best friend family” to join forces after New Brunswick allowed bubbling. The families lived nearby, traveled together, spent Christmas Eve together and have children of a similar age (Globe and Mail, May 2, 2020).”

“Saturday morning,” said O’Sullivan, “I was gardening and I thought, uh oh, I better contact them and see. I felt rushed because I thought everyone’s going to ask them. They’re like the coolest family in town. It’s like asking someone to the prom: Were they already taken?”

It turned out that they were taken. Instead, the “best friend family” had bubbled up into a group of eight: two husbands, two wives and four kids.  O’Sullivan’s parents paired up with her sister. Her best friend family’s parents decided not to break their quarantine. Bubbling can leave you feeling left out.

Bubbling requires commitment, like going steady or being in a monogamous relationship. For instance, the chances of contracting a sexually transmitted disease is extremely low in a monogamous relationship, but increases sharply if one or both partners cheat.

You can’t play the field. Dr. Henry says: “What you can’t do is see two people one night and four different people the next.”

Bubbling reduces the isolation of singles. Daycare and work-time access improve.

An Edmonton couple, both who work and have a two-year old, bubbled with another working couple with two-year old forming a makeshift family of six.  They care for the children on alternate days: While one parent goes for walks, or does arts and crafts with the kids, the other three parents can work a full shift uninterrupted. They rotate a biweekly grocery run, one person shopping for both families. As a courtesy, they text message each other whenever anyone leaves the house for errands, a walk or a drive.

Mental health improves with socialization. Some sense of normalcy returns to these crazy times.

However, what legacy will remain once the pandemic is over. Will you remain close to those in your bubble?  Will those not included feel slighted or shunned?

And how will you feel about the “others’” outside your circle? The stain of disease is deeply engrained in the human psyche. If they didn’t meet your standards of hygiene, can they ever be trusted?

 

Ageism contributes to poor care in long-term facilities

The COVID-19 pandemic has made it clear the disparity of care for residents in long-term care compared to that in hospitals. An indicator of that disparity is the fact that 80 per cent of COVID-19 deaths have been in long-term care homes so far.

image: mybetternursinghome.com

I’m avoiding the label of “the elderly” for these residents for reasons I’ll explain later.

The reduced long-term care is not for lack of dedication by workers but for political reasons. Barb Nederpel, President of Hospital Employees’ Union, told me:

“The pandemic has brought the problems in how we treat seniors and those who care for them into sharp focus. Twenty years ago, workers in long-term care earned the same wages and benefits regardless of their employer. Through privatization and contracting out, the BC Liberals forced thousands of these workers into lower paid jobs. Many took second or third jobs to make ends meet. To keep seniors and workers safe during the pandemic, public health officials are limiting workers to single sites and we’ve secured agreement from government to increase those wages back to the industry standard.”

For ideological motives, the BC Liberals argued that private care facilities could operate more efficiently. Privatization created a multi-tiered system where those who could pay more got better treatment.

The trouble with this model is that in this market where there is a labour shortage, workers will go to where they are paid more -leaving places that pay less short-staffed. The residents who call those places home suffer.

Ageism is at the heart of deaths in long-term care homes. The reduction in worker wages reflects the degree that we care about the residents of those facilities. The death of “the elderly” is seen as no big deal. People get old and die. The meme “Boomer Remover” that has been circulating reflects the dark humour of ageism.

To dismiss residents as “the elderly” robs them of their dignity as fathers and mothers, grandfathers and grandmothers, brothers and sisters. Let’s call them persons; persons who love and are loved, who laugh and cry, and make a difference in the world. Age should be just one aspect of anyone’s life, not a defining attribute.

Hospitals are relatively well-prepared for the pandemic in contrast to long-term care homes says Rona Ambrose, former Conservative minister of health and minister during the Ebola crisis in 2014:

“Our hospitals are ready. Doctors and nurses have been properly trained and are waiting to be called in for COVID-19 duty. Personal protective equipment is available, and, if not, it’s on its way.

“Meanwhile, caregivers in many long-term care homes are underpaid, lack training and don’t have PPE. How could this have happened when we knew from day one that long-term care homes would be centres of COVID-19 infection? How could we have failed our care-home residents so badly? There are hundreds of these facilities dealing with outbreaks across Canada (Globe and Mail, April 13, 2020).”

Post-pandemic, we will need to reset our values so that workers’ wages coincide with the value that we place on them. It’s too bad that it takes a pandemic for that disconnect to sink in. There has been an outpouring of appreciation for workers who have put their lives on the line to serve us. Let’s back up that appreciation for long-term care workers with a living wage.