Get Ready To Dance, Alberta

We’re loosening pandemic restrictions in Alberta. It’s a necessary step, but one that is fraught with risk.

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We can dance if we want to, we can leave your friends behind
Cause your friends don’t dance and if they don’t dance
Well they’re no friends of mine

Men Without Hats

A blustery west wind swept down from the Rockies in the early hours of Friday morning, shaking and rattling my house as I tossed and turned in my bed.

I climbed blearily into my trusty Suburban later that morning and headed to Costco to stock up on groceries. The speed limit sign on the road leading out of my neighbourhood caught my attention: the limit had morphed from 60 to 9 overnight, underlined by unreadable Russian.

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There was a simple explanation, of course: the overnight gale had knocked the sign askew. It hung upside down, swaying slightly in the morning breeze.

I resisted the impulse to hit the brakes and carried on my way.

The dislodged sign struck me as an apt metaphor for the impact of the COVID pandemic: our world has been flipped upside down; the lockdown has slowed the pace of life to a crawl; and the way forward, it seems, is largely indecipherable.

An hour later, my Suburban crammed with supplies, I made for home. I turned on the truck radio to the sound of talk show host Danielle Smith interviewing John Carpay as he lambasted Dr. Deena Hinshaw, Alberta’s Chief Medical Officer of Health, for her decision to implement the lockdown in the first place.

Mr. Carpay — the executive director of the Justice Centre for Constitutional Freedoms — suggested that Dr. Hinshaw utterly failed to consider the grievous economic and social impacts of her lockdown decisions. As anyone who knows anything about the robust education and training of public health physicians can readily attest, nothing could be further from the truth. The intimation that Dr. Hinshaw recklessly moved ahead with lockdown without carefully weighing all of the ramifications is both misinformed and deeply disrespectful.

Public health doctors have an extraordinarily tough gig. In the face of crises, they introduce public health measures; when the measures work well, far less people die as a result. But since less people die than predicted, those measures are loudly and scornfully dismissed as draconian overreach by non-experts like Ms. Smith and Mr. Carpay.

Dr. Hinshaw, thankfully, isn’t too fussed by wrong-headed criticism. Her steady composure and unflagging leadership under duress has earned her deep admiration from most Albertans.

Let’s engage in a thought exercise: A large squadron of airplanes carrying 100,000 skydivers heads to 14,000 feet. On the strong recommendation of the squadron leader all of the skydivers put on parachutes before jumping. All the parachutes open safely — except for two, whose unfortunate wearers plummet to their deaths.

Overall, 99,998 out of 100,000 skydivers survived. Only two people died.

The fatality rate for the 100,000 men jumping from airplanes in this scenario is a measly 0.002%. Inversely, the skydivers as a group had a 99.998% chance of NOT dying from skydiving that day.

Surely no one would conclude, based on that vignette, that wearing a parachute is draconian overreach — that the parachutes weren’t needed.

As of this writing, 95 Albertans have died from COVID-19, out of almost 4.4 million citizens. Ergo, the fatality rate due to COVID-19 amongst the population of Alberta is 0.002%.

If you’re an Albertan, there’s a 99.998% chance that you have NOT died from COVID-19.

The lockdown worked.

The lockdown was our parachute.

Surely no one would reasonably conclude that the lockdown was draconian overreach — that the lockdown wasn’t needed.

The lockdown slowed the spread of COVID-19. It bought us critical time to strategize, to build up supplies, to train personnel, to plan for our long battle with this virus.

Nevertheless, the second-guessing is endless. Armchair “experts” are thicker than ticks on a coonhound in Mississippi. Most have no grasp whatsoever of the complexities of the coronavirus crisis. Most would do well to remember the old adage: “Better to remain silent and be thought a fool than to speak and remove all doubt.”

As I listened to Mr. Carpay and Ms. Smith maligning Dr. Hinshaw on Friday, I was struck by the utter pointlessness of their discussion. We can argue until we’re blue in the face about whether the lockdown was needed or not. But the fact is it’s done. We locked down.

We can’t go back. We can only move forward. As indeed we are: on Thursday Premier Jason Kenney and Dr. Hinshaw introduced a staged plan to lift restrictions.

Alberta and many other jurisdictions have followed a similar game plan, one laid out most articulately by engineer and data analyst Tomas Pueyo. Mr. Pueyo, while not an epidemiologist, has emerged as one of the most impeccably informed and rational voices during this crisis. In an influential essay published on March 19 titled “The Hammer and the Dance” he said:

“If you hammer the coronavirus, within a few weeks you’ve controlled it and you’re in much better shape to address it. Now comes the longer-term effort to keep this virus contained until there’s a vaccine.

After the hammer, after the strict social distancing and stay-at-home orders, comes the “dance” — the gradual and flexible process of easing back into a semblance of typical social interaction: a new kind of normal.

Pueyo again:

“I call the months-long period between the Hammer and a vaccine or effective treatment the Dance because it won’t be a period during which measures are always the same harsh ones. Some regions will see outbreaks again, others won’t for long periods of time. Depending on how cases evolve, we will need to tighten up social distancing measures or we will be able to release them. That is the dance… a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare.”

We’ve successfully hammered down COVID-19 in Alberta.

We haven’t wielded the hammer perfectly. We haven’t always hit the nail on the head. Sometimes we’ve missed it entirely (consider the Cargill meat plant fiasco, for example).

But we’ve done pretty well overall. We have some breathing room, a chance to lift restrictions, an opportunity to begin to dance.

We haven’t reached the peak of infections, but we can cautiously reopen. We’ve squashed the curve so much that the peak ahead looks more like a hill. Our hospitals will almost certainly not be overwhelmed.

But it’s hugely important that we don’t become complacent. We must not let our guard down.

The coronavirus remains the coronavirus, the same virus that decimated Italy, Spain, New York and scores of other jurisdictions. If it establishes deep roots here it won’t treat us differently just because we’re Albertans.

That we need to reopen isn’t really in question. We can’t stay locked down forever. We can’t win our eternal war with microbes by avoiding them completely. We can’t avoid COVID-19 entirely — it has become part of our world.

There’s no happy ending to this story — we need to face up to that, and work toward the least unhappy ending possible.

Note that Dr. Hinshaw used a hammer — not a sledgehammer. There’s no value in flattening the curve if we smash the economy to bits in the process. The cost — in terms of human suffering and death in the months and years to come — would far outstrip the death toll extracted by COVID.

We need to cautiously restart our businesses. We need to begin to rebuild.

We mustn’t allow people to suffer and die from medical causes neglected due to single-minded focus on COVID-19. Postponed surgeries and other necessary medical services must move ahead as soon as possible.

Life is in the living. We’d best get busy dancing.

That doesn’t mean we should throw caution to the wind.

It means that we should dance as if our lives depend on it. Which means observing proper social distancing, avoiding crowds, wearing masks in public, working from home whenever possible, staying home when sick, getting tested for COVID when indicated, and washing our hands frequently and properly.

We must choose our dance steps carefully and our dance partners wisely. To paraphrase the Men Without Hats: if our friends won’t dance, then they’re no friends of ours.

We would do well to remember, as we dance, those most at risk if we fail: the kid down the street with leukemia; the neighbour with rheumatoid arthritis; the spouse with diabetes; the co-worker with a kidney transplant; the elderly among us who sacrificed and built this country; the doctors and nurses and the many others who staff our hospitals; the grocery store workers and checkout clerks who are keeping us fed and supplied.

We’re dancing for them.

How long this will go on is unclear. Months, at least. Perhaps even years. No one knows for sure.

Inevitably, as we learn to dance, we’ll put a foot wrong here and there. We’ll step on some toes. It’s tough to master the tango overnight.

But we’ll get it right, for the most part. We’ll get through this together. We’ll survive. More than that, we will thrive: a bet against Albertan grit and ingenuity has been a losing bet throughout history.

We’ve had our share of tough times in Alberta, although we’ve never faced obstacles like this.

We’ve been knocked down harder and longer than ever before.

But Albertans don’t stay down.

We always get back up.

And this time we’ll dance.

So that we don’t get hammered again.

Originally published at on May 3, 2020.

Pediatric Emergency Physician

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