As we enter what are likely the end stages of the Covid-19 pandemic with the virus transitioning to an endemic state, our society has become angry and self-righteous, egged on by our political and chattering class. Pandemics at some point in their trajectory often find someone to blame. During the Black Death, the Jews made for an easy scapegoat, and in more modern times homosexuals served as the perfect minority to hate and blame during the beginning of AIDS pandemic. The pattern is always the same – find a group that nobody likes, claim that they are the party most responsible for the on-going disease, and then pour all of our hate and derision on them. Use political power to punish them and satiate the mob’s need for retribution. Today, with Covid-19, society’s scapegoat is the unvaccinated. Yes, people should get the vaccine; yes, they are safe and effective at preventing serious complications, especially for high risk populations, but a near religious fervor has gripped Canada in blaming the unvaccinated for our current woes with a near insatiable appetite to punish.
The story sells itself. Unvaccinated people are much more likely to experience severe illness, hospitalization, or death, especially if they have comorbidities. Currently in Ontario about half of the Covid-19 ICU patients and one quarter of all Covid-19 hospital patients are unvaccinated even though they only represent about 10% of vaccine eligible citizens. Clearly the unvaccinated are highly disproportionate in their need for health care services should they contract Covid-19. Yet the unvaccinated are in fact scapegoats for much larger problems.
The vaccines are not particularly effective in controlling the spread of Covid-19. With the rise of the Omicron variant, Covid-19 is so transmissible that the argument for externalities completely falls apart. The Covid-19 vaccines almost exclusively provide their protection to the person receiving the vaccine, conferring negligible spillover effects in the form of transmission interruption in the wider community. Thus, the refusal to take the vaccine, however misguided, only hurts the unvaccinated person. Most professionals recognize the ineffectiveness of the vaccines to control transmission. Hence, even with 90% of eligible Ontarians vaccinated, we see tens of thousands of new cases per day leading to explosive exponential growth in the vaccinated population. However, politicians and the chattering class argue that the unvaccinated play a special role because they disproportionately place demand on the health care system.
To get a sense of our problems, we can look to our health professionals on the ground. An emergency room physician, Dr. Brett Belchetz, told Global News “We are looking at hospitals that are struggling to keep up and now you add in all of those extra patients…we are in a dangerous situation here. You see patients being treated in the hallway with regularity and often that is just a choice we have to make — provide no care or provide hallway care.” An anonymous nurse added, “the volume of patients is insane. We are so overcapacity.” Dr. Belchetz continued, “It doesn’t take a mathematical genius or an expert in health care to understand that having more people in the province, especially people that are older, that are sicker, with fewer hospital beds, is a recipe for hospitals to operate overcapacity. And not just overcapacity — dangerously overcapacity.” It gets worse, Michael Garron Hospital, formerly Toronto East General Hospital, has postponed seven cancer surgeries as a result of a shortage of beds in the ICU since December. Carmine Stumpo, vice-president of programs at Michael Garron Hospital, says it’s been a juggling act for surgeons, “So we work with our hospitals to ensure that sort of situation hopefully is completely avoided, but if it’s necessary it’s minimized.” Serious issues for sure but these are not stories from this winter or even last winter; they are from the flu season of 2017-18! Ontario hospitals have been in an overcapacity crisis long before Covid-19.
If all the unvaccinated had been vaccinated, Covid-19 would still be over-running Ontario’s health care capacity. Data on the comorbidity status of the unvaccinated is not readily available, but at least some of them would have still ended up in the hospital and the ICU vaccinated or not. Eliminating a quarter of the Covid-19 hospital cases in Ontario still leaves us terribly strained. Canada has one of the worst health care capacities in the developed world and vaccinating the last 10% of our population is not nearly enough to hold the ground against the Omicron wave. The unvaccinated are not the cause of hospital overcapacity but they allow our governments to distract us from their failure to build a robust health care system, and their additional failure to build adequate Covid-19 specific health care treatment capacity. Even though we have been trudging along with a broken health care system for decades, which Covid-19 has exposed for all to see, our political class can now just blame the Covid-19 unvaccinated. It’s an easy way out.
Blaming the unvaccinated is bad enough, but the Ontario government’s lockdown policies create a super regressive health care tax. The argument for lockdowns is that, at this point, they are the only way to protect our health care system. I doubt that the lockdown approach is correct, but even if it is, the people who pay for that protection are the working class who can’t find timely daycare for their children and who find themselves locked out of work. They pay the “health care tax” in-kind today, protecting the health care system, to make up for what wasn’t paid earlier. And all the while the laptop class enjoys full salary and the opportunity to work in their pajamas. We’re all in this together….yeah right we are.
How did we get here? Canada has large structural issues that are undermining our democracy and harming our institutions. These problems go well beyond Left vs Right or any political stripe. Our country has not properly addressed its regional composition either in the BNA of 1867 or the Constitution Act, 1982. Instead of a properly constituted federation in which representation by population is tempered by strong regional power, we have quasi-federalism or some kind of hyphenated federalism (executive-federalism, collaborative-federalism, shared-cost-federalism, fiscal-federalism, etc.) and in that regard governments responsible for delivering programs become increasingly divorced from the government that raises the revenue. By constitutional necessity, Canada leans on Ottawa’s spending power to address regional needs which has had the perverse effect of turning health care funding into a circus of side deals between the provinces and the federal government, not to mention the complexities of indigenous health care delivery. The locus of decision-making shifts like sand dunes across the political landscape, making it difficult for the public — and at times even Parliament itself — to hold the appropriate government and decision-making body to account. We have deep structural institutional and democratic problems in Canada which Covid-19 has laid bare through our health care systems. Blaming the unvaccinated for our difficulties in the current Covid-19 Omicron wave distracts us from the important work that lies ahead of us not only for our health care systems but for the health of Confederation itself.