{"id":50099,"date":"2021-04-20T08:01:29","date_gmt":"2021-04-20T07:01:29","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50099"},"modified":"2021-04-26T17:42:39","modified_gmt":"2021-04-26T16:42:39","slug":"peter-brindley-covids-third-wave-another-wake-up-call-for-a-complacent-world","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/04\/20\/peter-brindley-covids-third-wave-another-wake-up-call-for-a-complacent-world\/","title":{"rendered":"Peter Brindley: Covid\u2019s third wave\u2014another wake-up call for a complacent world?"},"content":{"rendered":"<p><span style=\"font-weight: 400\">It\u2019s generally fine to be ignored if everything is going to plan. My nation, Canada, and my profession, intensive c<\/span><span style=\"font-weight: 400\">are<\/span><span style=\"font-weight: 400\"> medicine, is usually happy with this arrangement. The current worldwide attention on both is because of Canada\u2019s woeful covid-19 vaccination performance, and a growing third covid-19 wave. [1,2] Our national \u201csages\u201d (and I accept my portion of blame) continue to shuffle papers and lecture dispassionately about \u201cstaying the course.\u201d Meanwhile, your average Canuck tries to make sense of it all despite weary resignation and significant despair.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">It\u2019s not easy fighting an unprecedented novel mutating virus. Regardless, the attention on Canada and its ICU\u2019s is because we have all the variants, too few vaccines, and excessive fatigue. Our current response might also reflect that we have had life too good for too long. Regardless, I am committed to the cause and grateful that, even at our worst, we are luckier than most. It even feels indulgent to complain while inhabiting a rich nation, and plying a lucrative trade, but, I want to leverage the attention to encourage a third-way between denial and panic. I just want <\/span><span style=\"font-weight: 400\">Canada and its <\/span><span style=\"font-weight: 400\">patient care to be so quietly competent that the world focuses its attention elsewhere.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">My profession has done well on the covid-19 frontlines, but one of covid\u2019s many lessons is that we need to do better in the backrooms. After all, meaningful change requires sustained engagement, not just polemicizing. It\u2019s tough to know the right dose of fear, but, in terms of disaster preparedness we needed to waft the smelling salts long ago. Instead, I just read incredulously that Canada was named the top country in the world for 2021, despite ranking below 20th for administered covid-19 vaccine jabs. [3,4] This is hardly the time to encourage complacency.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Our national story (it is just as often a myth) is that Canada just gets the job done with minimal fuss. Regardless, like all rich industrialized nations, we can be smug and prone to virtue-signalling. Our particular brand usually includes unwarranted superiority, especially when comparing ourselves to our \u201cexcitable\u201d American cousins and \u201cstuffy\u201d British parents. Our lower early death rates from covid-19 (under 25,000 to date) fed that bias and complacency. However, the top three issues in Canada are now vaccination, vaccination, vaccination. This is a large part of why Canada\u2019s per-capita rates of covid-19 are now higher than the UK and US. [4] Covid-19 highlights that \u201cwell-done\u201d matters more than \u201cwell-said.\u201d<\/span><span style=\"font-weight: 400\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Canada\u2019s vaccination performance also shows the world that minimal preparation cannot be overcome, even with eye-popping expenditure. In just one year, my once thrifty nation has already spent more on covid-19 than any other project in its history: 380 billion Canadian dollars have been spent for a population of approximately 38 million. This is 50 times Canada\u2019s overseas aid budget, and enough for at least a hundred new hospitals. My take home: never equate cost with value, and never believe any official who says there is simply no money.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Canada is a G-8 country, but currently has zero\u2014I repeat zero\u2014ability to make its own vaccine. Instead we tried to bogart more vaccine than any other nation: <\/span><span style=\"font-weight: 400\">at least <\/span><span style=\"font-weight: 400\">four doses for every citizen. This nation routinely lectures others on social justice, but, along with other rich nations, we also withdrew vaccines from an international vaccine sharing pool (COVAX), intended primarily for poorer nations. [6] In other words, are we really \u201call in this together\u201d or are we just better at slogans. Even if the entire world is facing the same storm, the industrialized nations do not seem to want to share the lifeboat. So, what to do? We could start with the most clich\u00e9d of Canadian responses: an apology.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Canada loves apologizing so much that this is the punchline to why our national chicken crossed the road (i.e. to say sorry). So where is the vaccine apology, or meaningful acceptance of responsibility. I have only heard blame: \u201cIt\u2019s those that aren\u2019t wearing masks\u201d say those charged with getting vaccines; \u201cIt\u2019s the federal government not us\u201d says the provinces (the Canadian version of a US state) and vice-versa.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Which brings us to Canada\u2019s myth of national unity. Notably, Canada\u2019s coronavirus response has been mostly provincial (i.e. regional) not national. Canadian parochialism even includes our provinces competing for healthcare workers. [6] Even if doctors and nurses had the time to help out, Canada\u2019s medical practitioners still do not have national licences. As such, we can\u2019t work elsewhere because our national bureaucracy is as thick as maple syrup, and there are more restrictions than you can shake a nasal swab at.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Just to get a license in another province currently costs each individual thousands of dollars and days of paper work. To put this in UK terms, imagine re-applying and re-paying the General Medical Council every time you moved county. The result is that Canadian healthcare workers cannot be flown into hot spots even though our firefighters routinely are. There are also major provincial travel restrictions during covid-19. Presumably, one week of working elsewhere could necessitate five weeks away from your home hospital: if you quarantine 14-days upon both arrive and departure. Sure, Canada comes together when we play Russia at hockey, but for <\/span><span style=\"font-weight: 400\">c<\/span><span style=\"font-weight: 400\">ovid-19, hell no.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Like most countries, Canada has a complex history: most of it grand, some of it not. Regardless, we were previously known for tackling big challenges. We left footprints because we put work boots on. I love this country, but I am tired of unwarranted halo-polishing. Similarly, I used to think that healthcare was too big to fail; I now worry we are too big and too frail. If the best predictor of future performance is current performance, then I am no less concerned about the post-covid world. Unfortunately, those discussions will be ignored until we accomplish something as seemingly banal as getting enough vaccines into enough willing arms.\u00a0<\/span><\/p>\n<p><em><strong>Peter Brindley<\/strong>,\u00a0Department of Critical Care Medicine, Department of Anesthesiology and Pain\u00a0Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada.\u00a0Scholar, Peter Wall Institute for Advanced Studies. <strong>Twitter<\/strong>\u00a0<a href=\"https:\/\/twitter.com\/docpgb?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor\">@docpgb<\/a><\/em><\/p>\n<p><strong>Competing interests<\/strong>: none declared.<\/p>\n<p><b>References:<\/b><\/p>\n<ol>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/www.theguardian.com\/world\/canada\"><span style=\"font-weight: 400\">https:\/\/www.theguardian.com\/world\/canada<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a style=\"background-color: #ffffff;font-size: 1rem\" href=\"https:\/\/health-infobase.canada.ca\/covid-19\/vaccination-coverage\/\">https:\/\/health-infobase.canada.ca\/covid-19\/vaccination-coverage\/<\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/www.usnews.com\/info\/blogs\/press-room\/articles\/2021-04-13\/canada-is-the-no-1-country-in-the-world-according-to-2021-best-countries\"><span style=\"font-weight: 400\">https:\/\/www.usnews.com\/info\/blogs\/press-room\/articles\/2021-04-13\/canada-is-the-no-1-country-in-the-world-according-to-2021-best-countries<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/www.theguardian.com\/world\/2021\/apr\/16\/ontario-coronavirus-police-powers-covid-canada\"><span style=\"font-weight: 400\">https:\/\/www.theguardian.com\/world\/2021\/apr\/16\/ontario-coronavirus-police-powers-covid-canada<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\"><a href=\"https:\/\/nationalpost.com\/news\/canada\/heres-the-eyewatering-debt-canada-is-racking-up\">https:\/\/nationalpost.com\/news\/canada\/heres-the-eyewatering-debt-canada-is-racking-up<\/a><\/span><\/li>\n<li style=\"font-weight: 400\"><a style=\"background-color: #ffffff;font-size: 1rem\" href=\"https:\/\/calgary.ctvnews.ca\/alberta-says-no-to-ontario-request-for-health-care-workers-\">https:\/\/calgary.ctvnews.ca\/alberta-says-no-to-ontario-request-for-health-care-workers-<\/a><span style=\"font-weight: 400\">1.5390489<\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It\u2019s generally fine to be ignored if everything is going to plan. My nation, Canada, and my profession, intensive care medicine, is usually happy with this arrangement. The current worldwide [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/04\/20\/peter-brindley-covids-third-wave-another-wake-up-call-for-a-complacent-world\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":50100,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[263,18895],"tags":[],"class_list":["post-50099","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-global-health","category-peter-brindley"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Peter Brindley: Covid\u2019s third wave\u2014another wake-up call for a complacent world? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/04\/20\/peter-brindley-covids-third-wave-another-wake-up-call-for-a-complacent-world\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Peter Brindley: Covid\u2019s third wave\u2014another wake-up call for a complacent world? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"It\u2019s generally fine to be ignored if everything is going to plan. 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