Bully: "a person who habitually seeks to harm or intimidate those whom they perceive as vulnerable."
An article in Psychology Today (1) suggests the following responses for dealing with a bully:
Be Confident.
Stay Connected.
Use Simple, Unemotional Language.
Set Limits.
Act Quickly and Consistently.
Strike While the Iron is Cold.
In my opinion, we haven't put any of these suggestions into action and are losing the battle with the COVID-19 bully as a result. My aim in this article is not to debate the merits of the COVID-19 response to date. Rather, I want to address an issue that seems to be receiving very little attention.
Why are we treating the COVID-19 relaunch as a yes/no problem?
Instead, we should be treating it as multiple choice problem. One with may issues and thus an equal number of or more solutions. Never in the history of this country have we so readily accepted defeat and worse, been so excited to promote this defeat.
When are we going to stop being bullied by COVID-19?
2008-09 Global Financial and Economic Crisis
As you are well aware, this crisis did not stem from an underlining healthcare issue, rather from the surge and collapse of US housing prices, among other factors.
As per a House of Commons link (2), the Conservative government injected over $63 billion into the economy in an effort to combat the impacts of the global financial and economic crisis.
While the effectiveness of this government aid can be debated, the long-term impacts of the crisis on the health of Canadians is evident.
Impact of Economic Downturn on the Healthcare System
What are some of the impacts of economic downturns on the overall health of a nation? This article from Alberta Health Services (3) outlines some chilling details:
Utilization: Use of medical, dental and mental health services decline during economic downturns by approximately 7-8% for females and 25% for males. This could be a result of a lack of health care coverage due to layoffs. Based on other research, use of mental health care services increased by 11% for females and 9% for males. There was also a significant increase in prescriptions filled for opiates, antidepressants, sleep aids, and anxiolytics, one year after the Great Recession.
Unemployment Effects: Suicide rates increase over the first 5 years after the recession. Additionally, rates can remain high for up to 16 years after the recession ends. Inpatient costs related to discharges increase by 15%. Mortality due to mental and behavioural disorders, especially in seniors also increases. A rise in psychiatric illnesses causing hospitalization; including depression, anxiety, low self-esteem, and other factors can also be seen.
Populations Most at Risk: Typically those who are least educated are most likely to become unemployed as a result of a downturn in the economy. Other populations that are impacted include: low income families, young people, single parent families, ethnic minorities and children.
Preventative Measures: Active labour market programs can help unemployed individuals find work and offer hope and has been shown to significantly reduce suicide rates. Providing care for high risk groups and focusing on preventative measures and early care plays a significant role in mental health.
The article concludes that countries such as Sweden have experienced decreased suicide rates during times of crisis largely due to their investments in social welfare programs. When recessions hit, it is vitally important to manage resources wisely as decisions on where and how to spend limited funds becomes increasingly difficult.
Other Health Implications
A quality healthcare system requires funding to operate at peak performance. In order for this to occur, a nation's economy must also be operating at peak performance.
Few will argue that the economic backlash from COVID-19 will significantly outpace that of the Great Recession. According to the 2020 Fiscal Snapshot, the Liberal government is forecasting total program expenses for fiscal 2020-21 to be $592.6 billion. Yes, billion. Nearly 10 times the amount injected during the Great Recession (not considering inflation).
What is the impact of this spending on future healthcare delivery throughout the country?
This CBC article (4), states the following "After comparing estimates of expected cancer deaths with actual deaths from cancer during the 2008 to 2010 recession, they found that the downturn was linked with more than 260,000 excess cancer deaths among countries in the Organization for Economic Co-operation and Development (OECD) alone, Atun and his team said in Wednesday's online issue of The Lancet."
The above article from CBC did not consider other series medical conditions such as heart disease, diabetes, cerebrovascular disease, and others. One would logically think however, that there would be numerous excess deaths added in these categories as well.
Why the sudden spike in excess deaths from a recession that was not rooted in a healthcare crisis? Simple. A lack of healthcare funding results in missed screening, delayed diagnosis, and reductions in other preventative measures. As a result of delayed care, the cost of treating patients becomes much higher as well.
What Are We Supposed to Do?
Stop politicizing medical decisions.
Explore all potential COVID-19 treatments, specifically preventative options.
Realize that the response to COVID-19 is not linear.
Listen to entrepreneurs. They are known for being problem solvers.
End the practice of inter-provincial travel shaming.
Unleash the power of the free market. Tax dollars are needed to fund public health.
Learn lessons from the Great Recession.
Prioritize workers. Impacts of poor mental health are devastating.
Create adaptive, long-term solutions.
Think outside the box.
If you turn on the news, you most likely have heard that we are living in "unprecedented times". If that is the case, shouldn't Canadians expect unprecedented leadership and solutions?