In the past few days in Canada, we’ve been turning on the news to listen to our Prime Minister, Justin Trudeau, provide a daily update on COVID-19. He reinforces Canada’s approach to slowing the spread of the virus, the federal government’s efforts to support local businesses and the local economy and addresses questions regarding education, social supports, the healthcare system and our coordinated efforts with other countries.
As of April 4th, Canada has tested over 311,971 people, with 13,882 confirmed cases, 22 probable cases and 231 deaths from COVID-19.
Canada’s approach to controlling the pandemic has largely focused on issuing public health advice to individuals and businesses on social distancing practices (now referred to as physical distancing by several health agencies), travel restrictions including limiting all non-essential travel, emphasizing self-isolation for returning travellers and for those who are sick, encouraging people to work from home if they can, and advising all non-essential businesses to temporarily close.
The Canadian and provincial/territorial governments have also responded to the outbreak through free testing, contact tracing and surveillance. Canada has invested $27 millions in coronavirus research, specifically focused on testing and treatment. The Canadian response to the pandemic therefore relies heavily on trusting their citizens to follow the government’s advice. The effectiveness of the approach is reliant on individuals and groups following guidelines for social distancing, self-isolation and non-essential travel, as large-scale enforcement of these practices has not yet been implemented.
As the trajectory of the outbreak progresses, the Canadian government will likely consider the implementation of large-scale enforcement through measures like curfews and army enforcement of self-isolation and social distancing practices, similar to Italy.
International responses to the COVID-19 outbreak share a common goal of reducing the spread of the virus and preventing cases and deaths. With this common goal, come dramatically differing responses across nations.
The response from South Korea, with 10,237 cases and 183 deaths as of April 4th, did not include large-scale strict enforcement of curfews or lockdowns. Instead, the South Korean government enacted a broad screening program that has tested more people, per capita than any other country thus far.
Testing was free for anyone who fit certain criteria, and for a fee for anyone who did not meet the criteria.
Wide-scale testing allowed the South Korean government to collect a plethora of data which enabled them to pinpoint clusters, to perform epidemiological analyses of the outbreak and to implement control measures accordingly.
The president of the Korean Society of Epidemiology, Kim Dong-Hyun attributes the country’s success in responding to COVID-19 to their universal health care system.
For countries without universal healthcare, like the United States, the economic burden of testing is overbearing for individuals.Unlike South Korea, the United States does not ensure free testing for citizens who meet testing criteria, and testing alone can cost up to $300 USD. Treatment costs can exceed $30,000 USD.
In the United States, your ability to get tested boils down to private health insurance and your personal financial status.As of April 5, the United States has 304,826 confirmed cases of COVID-19 and 7,616 deaths, making it the new epicenter of the pandemic. With 8.5% of the country’s population without private health insurance coverage, and with an 11.8% poverty rate in 2018, millions of American citizens will not be able to afford testing or treatment for COVID-19.
The American healthcare system therefore plays a major role in the magnitude and length of the country’s outbreak, and unfortunately who will receive testing and treatment for COVID-19. The most marginalized and vulnerable in the country, who do not have private healthcare coverage and who cannot access or afford testing, will be the most affected by the outbreak.
As the virus continues to spread across the world, we, as global citizens, will witness a wide range of concerted and coordinated efforts to stop the pandemic. We will learn what has worked, what hasn’t, and what we can do moving forward to prepare for future outbreaks. The lessons learned from the COVID-19 outbreak may cause healthcare decision makers, governments and individuals to pause and re-consider their priorities moving forward.
Stephanie Wiafe (she/her/hers) is a Ghanaian-Canadian woman, currently located on the unsurrendered territory of the Musqueam, Squamish, and Tsleil-Waututh people. She is a highly skilled global public health professional and researcher, with a graduate degree in Public Health from Queen’s University and a Honour’s Bachelor of Interdisciplinary Health Sciences from the University of Ottawa. Steph has cultivated a career dedicated to global public health equity, working alongside communities that experience severe social exclusion, isolation and health disparities.