Reasons to keep calm over COVID
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Summary
In this episode of Full Comment, Dr. Isaac Bogos joins us to discuss the end of the COVID pandemic, and whether or not it's now over. Dr. Bogos is a staff physician at Toronto General Hospital, who is on the front lines of COVID throughout it all and became a familiar face on TV and radio to Canadians seeking help and advice navigating the pandemic.
Transcript
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I hope you had a good summer, and I hope you had a normal summer.
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The most normal summer you've had in the past couple of years.
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Because, of course, the COVID-19 pandemic is now over.
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And I pause, because that line, spoken right now, typically gets one of two reactions.
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Those who, I guess, nod in agreement, and those who strenuously object.
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Who say, it's not over just because you say it is.
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There are hardly any more COVID rules on the books, and for months now,
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life in Canada has gone on normally for the vast majority of people.
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Yet some people contend that this will change in the fall as respiratory virus season kicks in,
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Should we be concerned, or is this just fear-mongering?
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should we push for inquiries into what happened the past two years?
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Do we need to talk about things, relitigate things,
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whether we made the right choices, on a whole number of fronts, whatever your perspective.
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We've also begun something of a national conversation into our healthcare system,
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whether or not it's adequately equipped to deal with the challenges we face,
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COVID or otherwise, if it's time for healthcare reform.
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Dr. Isaac Bogosh joins us now to discuss all this and more.
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He is a staff physician at Toronto General Hospital
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who is on the front lines of COVID throughout it all
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and became a familiar face on television and radio to Canadians
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seeking help and advice navigating the pandemic.
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Well, I'll throw the, I guess, the both super tough but super simple question.
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Longer answer, we're in a much better place right now than we were a year ago and two years ago.
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And you can't act like it's 2020 anymore and you can't act like it's 2021 anymore.
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It wasn't as significant from a healthcare utilization standpoint as other prior waves.
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And I think if we say that it's over, it might, well, I think it conveys an inaccurate message.
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Just because there aren't really any mandates or we're not seeing much in the way of public health restrictions
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and public health measures, that doesn't mean the infection ceases to exist.
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And I think we can have open, honest, transparent conversations about, you know, what it is,
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how to protect ourselves, how to protect those around us, how to ensure that we can live as
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normal a life as possible, but still acknowledge that it is here and still is impacting us.
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What's the difference between saying the pandemic is still happening and saying, well, there's
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And now it's just in the backdrop of our lives like these other viruses.
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Is that the same thing or are those two different things to say?
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I think it's a lot of semantics and a lot of nuance.
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And again, just because you say the pandemic, if someone says the pandemic is still here,
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that doesn't mean that we should, you know, jump right to, you know, make a connection.
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It just acknowledges that the virus is still here.
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We're still having, you know, people get sick and die from it and to a higher rate than
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Like it still is a significant issue in Canada, whether we want to acknowledge it or not is
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But like if you were to walk through the hospitals or look at the death certificates or look at
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who's impacted by this, it's still having an impact.
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You know, and in the same sentence, I'll say it's having much less of an impact now as it
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We're in a much better place in a much different place.
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And of course, the rules and the regulations and the policies have to adapt to the current
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You know, if we want to call this endemic, we could.
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But endemic still means, you know, significant disruptions on our health care system and
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significant impact on on individuals and communities, particularly vulnerable individuals
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So would you say that what we could perhaps see this fall in this winter would be greater
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than what you think we're going to see with COVID-19 for the next 10 or 20 years?
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Or are you saying that what we're going to see this coming fall is what we should get used
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to seeing for quite some time with this particular virus in terms of volume of deaths and hospital
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I mean, short term is a lot easier to predict than longer term.
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But over the short term, listen, we know that, for example, in Canada, we've got a few
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Number one, yeah, at some point in the late fall, we'll probably see a rise in COVID.
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There's definitely some seasonal variation to this.
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Number two, we're going to see other respiratory viruses, including the flu.
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Like you look at the southern hemisphere, that's often an imperfect but still somewhat
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decent metric for what we're going to see in the northern hemisphere during our winter.
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And they had a pretty decent flu season, not decent, a pretty impactful flu season in
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Australia, for example, especially when we compare it to the last couple of years where
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So we're going to see flu and other respiratory viruses.
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We know that brings people into hospital as well.
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Then on top of that, you know, we've got other strains on our health care system that we had
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even before COVID, like every winter, every winter.
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You'd always see the headlines, you know, hallway medicine's an issue or we're overwhelmed.
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So we have to add that on to the existing pressures of the health care system.
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And then on top of that, I mean, it's not a secret that health care has been a really
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challenging place to work in over the last two and a half years.
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So we just don't have the same capacity to manage even smaller waves.
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I can't tell you how big it's going to be, but we're going to have one.
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But it's tough right now when it shouldn't be that tough.
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And if you fast forward a few months when it's going to get tougher, I mean, we still
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have to provide Canadians with the health care that they deserve.
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It's just harder and harder to do it with all the pressures and fewer hands on deck.
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How should Canadians then conceptualize what's going to happen then?
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Because when you referenced before COVID, there were the headlines, this hospital or Ontario
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hospitals in general overwhelmed at 110%, whatever the number was.
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And I don't think Canadians were unsympathetic to people in your position who are dealing
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But I think it was kind of like, all right, well, that doesn't really have too much to
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Unless, of course, I happen to go to the hospital and face a really long wait time and I'm frustrated
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But it was seen as this other thing happening somewhere else.
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Yet, of course, the past two years, the idea of hospitals being overwhelmed was something
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that was seen as our collective burden to bear and manage and restrictions are brought
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When we talk about upcoming hospital challenges, is this really a sectoral specific issue that
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is about government providing adequate services or and the public can no longer, well, let's
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face it, be stressed out about it, have anxiety over it?
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One is we can ignore it and stick our heads in the sand and just hope it gets better.
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But we know that's obviously not going to be a successful approach.
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The other one is to see, you know, we're obviously talking about health care and the
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hospital sector, but it extends well beyond the hospital sector and to other aspects of
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And we know people have had tremendous difficulty reaching their primary care provider or other
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health care, public health, whatever their health care needs are.
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And then, of course, it extends well beyond that.
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We know that this has impacted every other sector as well.
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We've had, you know, staff absences due to illness, outbreaks in, you know, indoor settings
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So, again, like this is not doom and gloom, not at all.
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Like, really, truly, I can't stress this enough.
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Things are so much better now than they were before.
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It's just that I think if we keep pretending that it's 2019, we're going to get smoked again
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and again, and we can take some simple steps to create safer indoor spaces to protect ourselves,
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to protect those around us so that this just has less of an impact.
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But we can limit their impact on on us and in our communities.
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But again, like, let's just take a step back and look at the last three waves.
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And then you had a spring wave that was also Omicron, BA2.
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But, like, between our really, really high vaccination rates in Canada, plus a lot of
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people having previously been infected rather recently, you had, like, from a health care
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standpoint, you know, a much smaller wave, like a really small wave.
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And again, very little in the way of mandates, very few masks, no restrictions on how many people
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And, you know, you had a wave, but it wasn't nearly as significant as the prior one.
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And we just we're coming out of a summer wave now.
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But again, like so many people have been infected and recovered, plus or minus have been vaccinated
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that we just see an impact, but just much less of an impact of this wave.
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So I think we have to think of this as, listen, we're a very highly vaccinated country.
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Yeah, there's room for improvement on boosters and in vulnerable populations.
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Yeah, we don't want anyone to get infected, but we can't ignore that a ton of people have
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been infected and recovered from infection, especially over the last six months.
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And that really goes a long way to building up community level protection and community
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level immunity, such that when we have the next wave that rolled through town, it just
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Very little restrictions, very little mandates.
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But from a health care system standpoint, from a death standpoint, it just was a much
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So, Dr. Bogosh, does the general public kind of know what they need to do now in terms of
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the if you're sick, stay home, something that a lot of people say we should have been doing
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that a bit more in the before times anyway, in terms of that people say, oh, no, I can soldier
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And then people who are high risk, I think we've been talking about for two years, they can
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adequately identify whether they are or not, and then they can respond accordingly.
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And then when it comes to, for instance, something I'm very passionate about, kids and
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COVID rules, I don't want my kids to even hear the phrase COVID again.
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You know, the small children, zero rules, zero, just leave them alone and we'll just
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I mean, are we are we informed enough that the people who need to do things a little
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I think we're getting there, but I'd say there's a couple of points there.
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You know, on the one hand, we are probably way more health literate right now as a country
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We're having public conversations of words like mRNA and rapid test.
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And it's like, did you ever dream in a million years you'd hear public debates over
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brands of vaccines like this is pretty impressive?
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So, yeah, on the one hand, sure, we're much more health literate and savvy, especially in
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the realm of public health and infectious diseases as a country.
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The second point is we also see the tremendous and profound negative impact of misinformation
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and disinformation from a well-funded anti-science movement.
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And again, I'm not saying that's impacting everybody, but that does impact a proportion
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of Canadian society and makes things more challenging.
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Because I hear these words bandied about a lot, misinformation, disinformation, and it's
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always interesting to drill down and say, what are we talking about here?
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Basically, misinformation, meaning unintended but wrong information about COVID, science,
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Disinformation, meaning purposeful, meaningful, false information, subverting public health,
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I'm not saying it's a problem for 100% of Canadians, but there are some that will listen
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to this and make poor decisions for themselves, whatever that may be, and it might cause harm
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So I would say we're very well, we've got certainly more health.
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Part two, we can't ignore misinformation, disinformation.
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And part three, I think one of the more important parts, too, is we've got different senior political
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and public health leaders saying different things.
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And I think that causes confusion in the general public.
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And if we had reasonable, and how, yeah, good luck, we're going to define reasonable, but
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reasonable, coordinated messaging that's science-driven, that's data-driven, that's
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reflective of whatever we want to agree upon is what Canada wants to do collectively, which
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But you've got, you know, Dr. A saying this, Dr. B saying something totally different, you
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know, public arguments and spats and policies that are contradictory.
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We have a lot of policies that are out of date as well.
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And I think that fuels a lot of mistrust and people tune out.
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And, and that's a problem because obviously we want common sense rules.
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We want meaningful policy to protect individuals and, and, and, and communities.
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And, and, you know, there's going to be a time where we're going to say, you know what,
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hey, everyone should get this booster vaccine and we want reasonable uptake for that.
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But if people are tuned out, you know, that we're just, we're just not going to see people
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So yeah, misinformation, I guess, from, from one category, from, you know, random online
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voices who are not credentialed to talk about what they're talking about, but I want to
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And I guess when, when you talk about doctors being inconsistent in what they're saying or
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disagreeing with each other, I don't know if misinformation is the term, but people
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I had a lot of frustrations with, again, talking about kids and COVID really almost looking to,
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to, to ham up the severity of the issue with children.
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I know you weren't allowed to say, you know, COVID is, COVID is not as bad as the flu or
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But when it came to children, the data set kind of has consistently shown that was more
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or less accurate when it came to, uh, deaths, a lot of things, particularly around the kids
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And one kind of goes, I wish we could have talked about these numbers more openly rather
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than doing, uh, the Ontario science table had, had the phrase, I know they didn't invent
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the phrase, but behavioral sciences nudging to, I guess, I don't want to call it stretch
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the truth a little bit to, I guess, make people not let their guard down.
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And, and, and, you know, obviously, uh, open, transparent conversations about what the data
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We see a lot of, you know, preconceived, or we see a lot of these ideology based, uh,
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decisions and, and opinions and people will cherry pick data to suit their preconceived
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And that's unfortunate because, you know, you see people digging in their heels, uh,
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you know, a lot of disagreements over policies, uh, and people using, you know, cherry pick
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And it's, it's unfortunate because like, you know, we can take a look at what data is available,
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Not all data is created the same, you know, have open discussions about it.
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It doesn't mean you're anti-vax or anti-science or anti-this or anti-that.
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Just have a meaningful discussion about what the data shows and make reasonable policy around
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We know that all the data available shows that kids just don't get as sick compared to
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And we don't want them to, of course, we don't want anyone to, but compared to older cohorts,
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kids just don't get as sick pound for pound as adults.
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The other thing that's okay to say and okay to acknowledge is, you know, the vaccines will
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reduce that already really small risk of severe illness pretty significantly.
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People get mad saying, oh, God forbid we should vaccinate the kids, but they do.
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It's also okay to say that these vaccines are really, really good, but of course they're
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And we can talk about what the waning immunity means over time, what the risk of adverse events
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Like these are, you just have to have open and transparent conversations without cherry
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pick data to give people a good idea of what, you know, what the science shows, how the policy
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is created from the science so that people can make smart decisions for themselves.
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Once you start selectively using data or buffing up one area or, you know, negatively discussing
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another area that you might disagree with, I think, again, people lose trust, they dig
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in and then you've lost the public and here we are.
00:20:13.160
Well, I think the vaccine issue, and tell me if you agree or disagree, is one of those
00:20:16.560
issues where there was risk of waning trust based on the almost absolutism with which it
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was discussed and the aggressiveness with which it was pushed.
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And we didn't give people breathing room about it and didn't give them room to talk it
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out. A phrase that was said quite a lot and is now kind of teased by a lot of people is
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And I just think what those terms mean have changed.
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When we first said, when we first heard that the vaccines were safe and effective, I think
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effective back then when it was first rolled out meant it stops transmission.
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When the phrase safe was first rolled out, well, that was before we pulled AstraZeneca for under
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40, before we pulled Moderna in, what is it, under 30 males.
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I mean, okay, well, what we mean by safe has shifted because we've clearly determined that
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some catchments, some criteria are not safe for some individuals.
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So again, we've kind of eroded the way we use these phrases.
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So like anything else, there's a lot to chat here, but in general, like anything else, you
00:21:16.620
talk about what is the benefit, what is the risk, what are the alternatives, and what is
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the context, you know, AstraZeneca is a great example, right?
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I mean, this was a, it was rolling out during the third wave.
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If you talk to people who work in hospitals, I'm not going to put words in other people's
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But that was by far the lowest point of the pandemic for many of us that work in the hospital.
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Never in my life have I heard about adults admitted to pediatric ICUs, tents set up outside
00:21:52.260
a hospital because we didn't have enough beds, bringing in healthcare providers from other
00:21:57.660
We, Ontario was getting pummeled in the spring of 2021.
00:22:03.060
So when you're having a conversation about AstraZeneca, you have to talk about what are
00:22:08.820
Yeah, this is going to keep you out of hospital.
00:22:12.920
Yeah, there is a risk and it's, you know, there's a range, probably about one in 60 to
00:22:23.520
Well, your healthcare system is disintegrating around you.
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There's COVID everywhere and we're dropping like flies.
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And that doesn't just mean you're at risk, vulnerable populations.
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We were admitting, you know, 20, 30, 40 year olds to the hospital as well during that time.
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And then the alternatives, the alternatives were, well, you can, if you're lucky enough
00:22:46.640
and you can wait it out, if you can isolate, not everyone has the privilege to isolate.
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But those are things that you have to have open conversations and contextualize it.
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But yeah, of course, when you have the gift of MRNA vaccines and other alternatives and
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there's lower rates and your hospital system is under much better control and you have
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Same is true for, um, uh, you had to, I was, I'm just losing it.
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You had another great example, but, uh, AstraZeneca, I believe was, was one of them.
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The other one being Moderna pulled for, for males under 30, uh, nationwide.
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Oh, the other one too, is, um, the risk of transmission.
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Listen, if you're asking that question about, you know, COVID vaccines, reduced transmission
00:23:34.760
and you asked, you know, in December of 2020 and in early 2021, we were dealing with the
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And when we were dealing with the alpha variant, uh, in the spring of 2021, and I would say
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to some extent, even during, uh, later on in the year when we had our Delta variant, yes,
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The vaccines really did have very good protection against reducing your risk of getting this
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And they really significantly reduce your risk of onward transmission.
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I mean, Omicron changed the game that just the, the, the rate of protection that these
00:24:16.660
vaccines had against infection and onward transmission declined substantially with the
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Omicron variant, which really emerged around December of 2021 and which we currently have
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It's not like they do nothing, but they do very little, uh, compared to what they did
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before for protection against infection transmission.
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I would say they still do a remarkable job in protecting us against severe infection.
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But yeah, if you're like, like you point out, if your policy is created to say, listen,
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we're, we're, we're, we want vaccines here because we want to stop transmission.
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Like you can reduce your risk of transmission, but to a much, much, much smaller extent compared
00:24:58.340
So again, open, honest conversations about what they do, what they don't do and appreciating
00:25:02.980
that things change with time as the virus changes and as we accrue more data.
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Isaac Bogosh's thoughts on university COVID mandates right after this break.
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For children in Ontario, they will face no mandatory COVID rules in elementary schools,
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I'm glad they don't have to wear the masks and face other rules.
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But if they're going to some universities in Ontario, they actually will face mask mandates
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at a few universities and Western university getting the most headlines for having the most,
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We should say a booster mandate in addition to a mask mandate.
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Isaac Bogosh, what do you think of universities going a bit rogue from provincial recommendations
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and saying we're going to bring in these stricter rules?
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When we talk about the vaccines, for starters, I think we are, you know, moving away from
00:26:01.260
And obviously, that's a, in my value judgment, is that's a good direction to be moving in.
00:26:07.640
And I will come out and publicly say that I very much agree that people should be vaccinated.
00:26:14.660
But, you know, I think, like anything else, we need to know what is, like, what's the goal?
00:26:21.240
You know, we're dealing with, for example, in universities, 18 to 22-year-olds.
00:26:26.060
Like, is the risk here to prevent more serious infection in that population?
00:26:30.040
Well, you know, these are individuals who've had two doses of a vaccine.
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And most of them have had an infection and recovered from infection.
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So how many of that age cohort did you see in hospital?
00:26:40.540
How many 19-year-old boys and girls did you encounter?
00:26:44.700
Like, otherwise healthy, two-dose vaccination, 18 to 22-year-olds, like, without underlying
00:27:01.000
And those people, you know, sadly, those individuals are overrepresented in hospital,
00:27:07.240
So, but without medical comorbidities, very few, few to none who have been vaccinated.
00:27:13.020
The other interesting thing, though, is, you know, if the goal is to reduce transmission,
00:27:17.680
yeah, I think you can acknowledge that the vaccines and the boosters still reduce transmission,
00:27:28.780
So you're not getting nearly the same bang for your buck in terms of reducing transmission.
00:27:34.140
And I think, you know, when you're saying third dose, there's just more and more evidence
00:27:39.340
pointing in the direction that people who've had two doses plus infection really have, you
00:27:47.100
know, based on, I'm timestamping this to, you know, August and September of 2022, but you
00:27:52.520
really have this, it's almost equivalent, if not equivalent to three doses of a vaccine.
00:27:59.380
So, you know, you sort of have to ask yourself, what's the, what's the goal of this policy?
00:28:04.580
And does this policy accomplish what we're, we're setting it out to do?
00:28:08.780
And you think too, I mean, again, I think these vaccines are in general safe, but yeah,
00:28:15.520
There are side effects associated with them, however rare.
00:28:18.580
And again, people will debate about what the actual rate is, but we know that myocarditis
00:28:22.500
is the risk is greater than zero, especially in younger, younger men.
00:28:28.840
And, you know, I, I think we can acknowledge that as well.
00:28:32.160
So when we were making a policy, I want to look at, you know, what do we try to accomplish
00:28:40.200
I mean, listen, and obviously university is a very different setting than, for example,
00:28:43.740
I don't know, a long-term care facility or a hospital.
00:28:46.940
Like, so I think the, you've got to have the right policy for the right, for the right
00:28:51.940
area, but nuanced conversations, looking at what the goals are and creating a policy to
00:28:55.740
achieve those goals is the right, right thing to do with total transparency as to how you're
00:29:01.180
Dr. Bogoch, looking back, do you believe that we pretty much made the right choices?
00:29:05.580
I mean, I've, I've written, I've argued that we do need some sort of investigations, public
00:29:08.820
inquiries only because of the gravity of what happened the past two years, both in terms of
00:29:13.140
the health crisis and that, that we did unprecedented edicts in our lives, things that governments
00:29:17.780
really haven't done before in, in modern history.
00:29:21.900
And I was always a big advocate for giving people a bit more breathing room.
00:29:25.220
If whatever the number of diehard unvaccinated people are, 9% of people, they really, really
00:29:33.260
I don't think we necessarily need to box them in as much as we did, or, you know, like
00:29:37.580
a small number of people just didn't want to wear the mask in the grocery store.
00:29:41.700
It's not a good use of resources kind of thing.
00:29:44.160
Do you feel confident with the advice and the recommendations and the things that happened
00:29:49.420
that those more extreme things, the, you know, you can't have your uncle over for dinner
00:29:57.040
So I think for starters, yeah, in general, I think it's a very important thing to look
00:30:04.360
And if we can do this with some objectivity, we'll be doing something right.
00:30:13.280
Like if we can have conversations in good faith about this, I think we can generate a
00:30:19.540
lot of meaningful discussion because, and we need to, because we're going to face this
00:30:33.720
I wish I knew, but like, come on, look in the last 20 years, you had SARS.
00:30:52.820
So different infection and therefore different rules.
00:30:56.960
You've had a big Ebola viruses out of epidemics, way outside of areas that we previously thought
00:31:04.600
You've had Zika throughout all of South America where, you know, it hadn't been seen before.
00:31:09.640
You had the Middle Eastern respiratory virus pop up in many different places, including
00:31:15.420
You've had an H1N1, the forgotten pandemic that started on a pig farm somewhere and spread
00:31:20.900
Like you could see, we have the recipe of encroachment on environments, environmental degradation,
00:31:29.060
blah, blah, blah, where viruses can jump into humans.
00:31:35.420
And if you have a transmissible respiratory virus, you can have another pandemic.
00:31:40.200
In the business, no one argues that that's, you know, a non-issue.
00:31:44.100
This is something that we think about a lot, even before COVID.
00:31:47.160
So we're going to have to figure out what to do with the next one.
00:31:50.000
And we have to also come to terms with some of the decisions that I think were the right
00:31:56.480
move at the right time and others that might have been disastrous.
00:31:59.720
And I think others, too, that might have, you know, maybe it was initially the right
00:32:04.820
But then we sat on these policies long past their expiration date.
00:32:08.580
And we didn't evolve with the evolving science or situation on the ground.
00:32:16.380
And again, people might yell and scream at me for this one.
00:32:22.160
OK, like, obviously, there's bigger fish to fry.
00:32:24.160
But this is just one little thing that bothers me.
00:32:27.000
Like, you know, maybe you could argue at a time and place that that was the right thing.
00:32:34.540
It would help screen people coming into the country.
00:32:37.700
But like, do we really need an Arrive Can app right now?
00:32:43.420
And again, that's small potatoes compared to other big policies.
00:32:46.520
But I'm just saying, like, we could really apply this to a lot of different areas and
00:32:54.180
But I think the big thing is, can we do this in an objective manner?
00:33:00.240
But if we can, and if we can get, you know, 20 smart people in a room from very different
00:33:05.040
backgrounds, maybe 100 smart people in very different backgrounds to critically appraise
00:33:11.300
our policies over time, look at what went well, what didn't go well from in a very objective
00:33:18.580
And it is interesting, though, that's important.
00:33:21.160
I think there's an underpinning philosophical divide of those who believe that when you're
00:33:24.740
facing a health crisis, whatever the severity, yes, the state should be doing these things
00:33:34.480
Danielle Smith joined us on this podcast a number of episodes ago to say that one of the
00:33:38.820
main reasons she was running for Premier of Alberta was to make sure there can never be
00:33:42.820
lockdowns and heavy handed restrictions again, whatever the issue.
00:33:48.320
I support protecting the vulnerable, shoring up the health care, more allocation of resources.
00:33:51.980
And I think she, not to speak for her, but I think she said similar things.
00:33:54.360
But I'm all on board with never those sorts of things again.
00:33:57.320
And I think you're going to be able to get people who are highly intelligent, informed
00:34:00.180
people in that room and have a full split on that question I put forward.
00:34:06.600
Well, I think the other point though, is like, we're sort of approaching this with a COVID
00:34:11.600
mindset, but like, why does it have to be COVID?
00:34:14.520
And again, let's think about a theoretical situation that it's a much more virulent, powerful,
00:34:20.760
damaging virus, like, uh, you know, the 1918, uh, flu epidemic that killed well over 50 million
00:34:30.660
Then we'll see our neighbors die and we'll go, oh crap, I'm not going outside because I don't
00:34:37.400
But then you think about what about essential workers who, you know, have no, you know,
00:34:42.960
that have to go to work or people that can't afford to stay home.
00:34:46.220
I mean, I just think we have to think about very different scenarios.
00:34:49.120
Like if you have something with, I'm just making it up.
00:34:51.300
What if it's got a, you know, there's bird flus that have, you know, 10 to 20% mortality
00:34:58.740
And I'm not saying it's going to happen, but I'm saying that people that look at epidemics
00:35:02.160
and pandemics are watching this really closely.
00:35:05.160
Uh, you know, we just have to make the right decisions for the right situation and for the,
00:35:13.640
And I'm not saying COVID was a cakewalk, right?
00:35:15.400
Like all the models think, estimate that over the last two, two and a half years, there's
00:35:19.740
been about, you know, 18 to 22 million deaths related to COVID.
00:35:28.360
And in the same breath, we can also say, Hey, they're, you know, lockdowns as horrible as
00:35:33.560
those are, you know, could probably reduce some transmission in the community, but also
00:35:39.140
have terrible negative consequences, which they do.
00:35:41.740
I mean, like it's okay to say that because it's true.
00:35:45.500
Dr. Bogosh, before we go, I want to get your thoughts on our conversation about national
00:35:49.460
healthcare for the longest time, for many years, we, we sort of looked down upon parts
00:35:57.400
And we had a bit of a narrative about the Canadian healthcare system.
00:36:00.760
But I know when we talked about Ontario, very aggressive lockdowns, a fourth lockdown, January
00:36:09.600
And then there was a lot of politicizing, a lot of mocking about, you know, Republicans
00:36:13.940
in Florida, but ultimately it seemed to come down to the fact that in Florida, they said,
00:36:17.240
well, we have the beds, you know, we encourage you to get vaccinated and take your precautions.
00:36:21.680
But if you get sick, we can, we can care for you.
00:36:24.160
In Ontario, we said, if there are 300 people in ICUs with COVID across the whole province,
00:36:33.600
It's like, wow, do we maybe have a little bit of a resources problem here?
00:36:43.920
One of the hospitals I used to work in, Massachusetts General Hospital, where I did a lot of my
00:36:47.320
training, basically added a, you know, turned their hospital into a giant ICU during
00:36:54.980
And there was a time where that hospital had basically more ICU beds than the province
00:37:03.340
Like one hospital in Boston had more ICU capacity than Alberta.
00:37:10.620
And to your point, I mean, the fact that we had to collectively crap our pants when we
00:37:18.500
were over 300 people, you know, admitted to ICUs with COVID related illness in Ontario,
00:37:24.900
because we just weren't going to have the healthcare resources to care for people like
00:37:31.880
And actually, just like we chatted about earlier, the third wave, which again, wow, was that
00:37:38.340
We had 900 people in Ontario, ICUs at one point in time with COVID related illness.
00:37:43.480
I can't tell you how horrible and awful that was, because the standard of care that Canadians
00:37:56.440
So we definitely have capacity issues in terms of bed per capita, ICU beds per capita.
00:38:03.160
We need to retain healthcare providers, especially nurses.
00:38:08.460
We need to train more healthcare providers, including doctors and nurses, but other allied
00:38:13.760
I think we need to be creative about this as well.
00:38:15.920
We can talk about facilitating credentialing healthcare providers that might have trained
00:38:22.780
Well, of course, maintaining the standards of care and the standard of education.
00:38:27.380
You know, I know privatization is a bad word in many areas, but I think Canadians would
00:38:34.300
be shocked to hear that there already is privatization within the Canadian healthcare system within, you
00:38:43.620
I think, obviously, if we look at the United States and get terrified, but there's other
00:38:48.040
models that aren't in the United States that may work in Canada.
00:38:52.780
And obviously, the United States is not the healthcare system to model ours after.
00:38:57.300
There would be others that we could look at that may do this more successfully.
00:39:01.520
But of course, at the same breath, we have to keep healthcare for everyone.
00:39:06.320
We can't provide, you know, substandard care for people that might not be able to afford
00:39:14.640
And we really have to ensure that all 38 million of us have timely access to high
00:39:22.140
And I know people have been talking about this for decades.
00:39:24.620
I'm not going to pretend to have the right answer to get there.
00:39:27.520
Dr. Isaac Bogosh, thanks very much for all you do.
00:39:48.620
This episode was produced by Andre Proulx, with theme music by Bryce Hall.
00:39:55.500
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00:40:00.480
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