14 April 2020

Doctor Aggie's H'Answer #nlpoli

“What do I have to do to get you to listen?” health minister John Haggie asked rhetorically and with considerable exasperation at Monday’s daily COVID-19 briefing.

Haggie was ranting once again about people across the province who he claims are flouting the restrictions on public comingling during the current health emergency.

On Monday, though, Haggie’s daily rants started to sound a bit more shrill and more than a bit condescending.

Anyone can appreciate his deep concern to prevent an outbreak of COVID-19 of the sort people have seen in Italy, New York City, or even Quebec.

But Dr, Haggie has the problem that the measures put in place so far have worked so well at containing the disease across the province that no one can see the danger in front of them.

And to be honest it is hard for the ordinary person to see the immediate danger, at least in the extreme way Haggie apparently sees it.

The trend is clear and important.
You see, the government’s own records do not show a couple of days of low numbers, as someone dismissively put it at the briefing.  There is a clear and unmistakable trend over the course of three weeks.  You can see it in the blue line in the chart at right.  

First week, a daily average of 18 new cases a day.  Second week, down to 12 cases a day. Third week – that is, last week – an average of three and a half cases a week. That is an unmistakable trend.

Given that the number of tests completed daily has been fairly steady, the decline in new cases is not due to a failure to detect sick people.  And given that people are scared of COVID-19 to the point of near panic in some senses, it is unlikely that anyone showing signs of being sick would not seek out medical help.

The number of active cases continues to drop.
Now consider the other important statistic, namely the increasing number of people who have recovered from COVID-19.  As of Monday, there are only 108 known cases of COVID-19 across the province.  That’s the same number we had at the start of the surge in new cases three weeks ago. And as the chart at right shows, the decline in active cases over the past week is every bit as steep as the increase was three weeks or so ago.

The upshot of all this is that while people could feel a sense of urgency in following restrictions three weeks ago, they can see the success of government measures in the numbers.  So, they may be a little looser in how they go about their lives.

While part of Dr. Haggie's problem is the success of government's efforts to constrain COVID-19, the rest of it is in the way Haggie and the political side of government talk to people. 

You see, there is little reason to believe people are being genuinely as reckless as Haggie’s rhetoric would have it. Nor is it appropriate to assume that people have not behaved intelligently enough using the information they have to judge whether there is a threat or not from mingling with family and friends whom they know are unlikely to be at risk of carrying infection.

Take as an example a family whose members have not traveled outside the province and who have been practicing social distancing and all the other restrictions the Chief Medical Officer has put in place.  Or take, as another example, two couples, who, likewise, know that they are at very low risk of carrying the infection base don government's information.

The fact that four of them got together over the Easter weekend or get together regularly does not put them at very great risk.  And it certainly does not warrant Haggie’s condescending assumption that they are deliberately and childishly ignoring the rule against five people being together in a group.

The answer to Dr. Haggie’s question is as simple to state as it may prove difficult to do.  To get people to heed his advice, Haggie  needs to stop talking down to them. 

He ought to treat them as the mature and intelligent people they are or, in some instances, as he wishes they would be. People can and will rise to the occasion. Given them the information they need and an honest assessment and trust them to use their best judgment to live up to the expectation.

Part of that information they need is an honest admission that the government’s precautions have  been successful. There is a potential for a slip, but for the most part we are in good shape.

Another part of the information is actually about how the government is telling people things not just what it is saying.  The daily briefings are more than stale.  They are stagnant.  The message is so repetitive that people have tuned out. And the tone, whether it is Ball’s bumpf or Haggie’s harangue or the stifling control of the media availability, is old-fashioned and ineffective. 

Professor Rahman’s Dog and Pony Show last week, full of assumptions and seemingly driven by the modeling as opposed to the actual experience on the ground, was not a break from the sterile trend but peak patronizing.  That government organized a secret briefing for reporters and banned them fro repeating any of what they heard or attributing it is unfathomably backward. That we have not got the slides and a written version of his presentation is simply inexcusable. 

People deserve more information not less. And they are overdue to be brought into the tent.  If we are really in it together, as the government lines say, then we need to be genuinely in all of it together.

We could excuse the government’s habitual paternalistic and patronizing approach for the first little while as this emergency came on everyone in a great rush. Years of habit is a hard thing to break. But things have settled down now and it is long past time for the government’s political face to come up to the professional standard set by the Chief Medical Officer from the start.   

Dr. Haggie asked a question.

There’s the answer he likely wasn’t expecting.

But it is the answer he needs to hear.