COVID-19 Responses Come Into Focus, But Road Ahead Remains Uncertain

Following Ontario’s release of its pandemic projections last week, Quebec and Alberta have followed suit, illustrating the impact of COVID-19 within provinces across Canada. The picture that is emerging is that the pandemic is hitting Canada’s provinces differently.

In Ontario and Quebec, the pandemic is on track to peak in the month of April and governments are seized with immediate concerns about health care system capacity and equipment to ensure front line workers are prepared to address the coming peak. The federal government is supporting this immediate effort, both through purchases of medical supplies and mobilizing domestic capacity, including through the order of 30,000 ventilators from Canadian companies.

The picture emerging in Canada’s western provinces shows a lower and slower crest for the pandemic.  In BC, the number of new cases reported has decreased since March 30.  Proportions of people who are hospitalized, and related fatalities, remains stable.  In Alberta, peak infections are expected in early to mid-May, indicating a slower velocity of infection. Alberta has also expanded its testing criteria and intends to expand it further, enabling a better understanding of the spread of the virus within the population and better health system preparedness.

A common theme exists across provinces: the worst is yet to come and public health measures must be sustained in order to ensure the curve is flattened and economic recovery can begin as quickly as possible. The degree to which we can mitigate the worst projections for Canada within the next 2-4 weeks directly relates to the actions taken today by Canadians and the decisions taken by public health agencies and governments over the past few weeks – particularly regarding vulnerable communities, long-term care, and Indigenous populations.

 Challenges will emerge as the epidemic manifests differently and at different times across Canada. These jurisdictional differences will also impact the duration of ongoing public health orders and the start of an eventual economic recovery. Layer on top of this the unique challenges facing the oil and gas sector to Alberta’s economy, and to a lesser but still critical extent the economies of Newfoundland and Saskatchewan, the road to recovery across Canada remains uncertain.

 Alberta rings the alarm bell

Alberta Premier Jason Kenney’s live broadcast to Albertans outlined the province’s approach to the three crises it faces: the public health crisis to fight the coronavirus; the shutdown of the economy leading to a deep global recession; and the collapse of global energy prices. To address the first of those crises and enable economic recovery, Premier Kenney warned Albertans it may be necessary to leave public health orders in place until the end of May.

Echoing Premier Ford’s statement in Ontario, Premier Kenney said that health and the economy are intertwined and that the sooner the pandemic can be stopped, the sooner the economy can begin to recover. However, the price of fighting the pandemic combined with the downturn in energy prices means that the recovery will be slower than the rest of the world. Alberta’s budget deficit will nearly triple this year, going from $7 billion to $20 billion, with a “fiscal reckoning” to pay for this expense still to come.

Kenney also outlined the province’s recent actions to take greater control of its economic destiny. In the oil sector, this includes launching discussions with US leaders about a coordinated defence of North American energy to protect against the “reckless” actions of Saudi Arabia and Russia and beginning construction of the Keystone XL pipeline. More broadly, Alberta committed $12 billion to its COVID-19 relief plan and appointed an economic recovery council to develop a plan to get out of the crisis. Absent from Kenney’s remarks was any indication of federal support for the oil and gas sector, which remain crucial for many Alberta-based companies.

To accelerate the path to economic recovery, Alberta also proposed to implement further public health measures, including:

1. Expanding Alberta’s world-leading testing rate to a targeted 20,000 tests per day to identify positive cases and those with immunity more quickly, so they can return to work
2. Expanding contact tracing
3. Implementing a more rigorous approach to screening arrivals at international airports (Kenney openly criticized the federal government for not closing borders sooner)
4. Strictly enforcing quarantine orders, including through smartphone apps
5. Encouraging and facilitating the use of masks in public spaces, such as mass transit

It is notable that some of these proposed measures, particularly increased arrivals screening at airports and the use of smartphone apps to enforce quarantine, have not been enacted by other levels of government, perhaps signaling some discontent with the federal response. Other measures, such as identifying people with immunity, are challenges that remain to be solved.  However, if Alberta can address them successfully, it will accelerate the province’s ability to move on to addressing its significant economic challenges.

Ontario seeks health system reinforcement

As part of efforts to maintain and extend public health measures around COVID-19, the Ontario government issued another call to action for healthcare workers in Ontario to increase the frontline capacity of hospitals, clinics, and assessment centres. A new Health Worker Matching Portal  has been established that will match the availability and skillsets of frontline health care workers, including health care professionals, students, and volunteers with health care experience, to employers in need of assistance.

This portal is open to a wide variety of workers with healthcare experience including those still in-training, retired, and foreign-trained medical professionals. While the government’s recruitment of foreign-trained professionals to support health care organizations falls short of longstanding calls to expedite the credentialing process, this is a first step to ensure the necessary flexibility around health care resources.

Similarly, in recent weeks the government has issued temporary orders to allow hospitals and long-term care and retirement homes the flexibility required to address emergency staffing needs and redeploy personnel as needed. This idea is not new – workforce optimization was a key recommendation from EY’s line-by-line audit to find efficiencies in provincial programs.

The reality is that these rapid changes around flexibility in the delivery of health care would have been very difficult in a pre-COVID-19 landscape due to the regulatory landscape and the need for consultation. However, situations that would typically create stakeholder management challenges for government have been set aside as government, health-system operators, unions, and front-line workers are all engaged in an “all hands on deck” approach that is needed to stop the spread of COVID-19.