04 May 2020

The trouble with bubbles #nlpoli

Another type of Bubbles

Stay in your bubble.

A cute, clever little phrase that Newfoundlanders and Labradorians have been hearing for weeks.

We all assume it means something like protect yourself as you go about your daily life. 

Or stay at home unless you have to go out.

And if that’s what it meant, if that’s all the phrase was, then the notion of a bubble is innocent enough.

Last week, though, Newfoundlanders and Labradorians found out “bubble” was something else.

As the province’s chief medical officer unveiled what she called the strategy for living with COVID-19, she outlined a series of what she called Alert Levels.  In Alert Level 4, people would be able to mix their one bubble with another bubble.

Except that the bubble mixing was allowed to start while we are still in the current state of alert with all its greater restrictions.

People wondered if they could safely mix with more than one bubble.  Like say, in families with two sets of grandparents close by.  Would they be able to go over and check on both of them without having to look at them from outside the house?  What if they had to go over and help out with a problem with the house. The kids would love to see nan and pop and maybe that would boost morale.

No, came the reply.  One bubble and one bubble only.  You pick.

Bollocks said your humble e-scribbler.  Inherently and in the circumstances in the province mixing more than two bubbles at the moment has about the same risk as mixing one bubble.

Whoa there, said someone else. There was a mathematically knowable risk of mixing more than one extra bubble right now.  Better be safe than sorry.

Not a mathematical problem at all, said your humble e-scribbler in reply.

Oohhh yes, it is, said the knowledgeable one, missing the point.

The difficulty is not in the math but in the concept.

First, no one knows what bubble means.  There’s no official definition of it. If no one knows what it means, then they cannot explain it to anyone else.  We can guess at a meaning but that is hardly satisfactory for such an important idea. If you cannot explain a bubble to someone, then that person cannot decide whether one action is riskier than another.  After all, the success of CVD restrictions depends on people being able to understand and apply the rules successfully.

Second, because there is no viable definition of what a bubble is, there is no way the officials can explain the connection between a given number of bubbles and a given risk of spreading COVID-19.

Mixing three bubbles could be the same as mixing two bubbles.  Or it could not.  This is not an issue where doubt should enter, let alone complete uncertainty. 

It’s not that we are facing an unknown problem and therefore some uncertainty is acceptable.   It’s that the whole concept of bubbles is just junk. 

Third, and much more significantly, there is no order issued in Newfoundland and Labrador since 18 March 2020 that says anything at all about bubbles or anything like them.


Last weeks stress throughout the province was caused by something officials couldn’t define and that wasn’t a rule anyway.  It was just a suggestion.

Now if the only thing that kept you from visiting Nan before now was the belief that there was a legal barrier, you just got a rude shock.  There isn’t one.  If you didn’t visit Nan and help her with a problem because you thought there was a law against it, then you have an even ruder shock coming to you.

Limiting your contact to as few people as possible is a good idea.  But there are situations where we all have to do things that are necessary.  You need to know the risks and know the facts in order to make an informed decision.

If you are taking a decision to act or not act because someone misinformed you, well, that’s simply unacceptable. 

One of the foundations of the relationship between government and the public in a democracy is supposed to be informed consent.  That means that people make a decision to support or oppose something knowing the likely consequences.  Doctors have the same obligation to their patients, incidentally so that just reinforces the point about informed consent during a health emergency. 

So, if government officials haven’t told us what is going on or haven’t been clear in what they are doing and why, then we have a very big problem.  A health crisis is not a good time for this to happen.

The problem gets bigger if government officials with considerable power over ordinary lives are confused about what is going.  Transforming bubbles from a cute comment to some kind of planning tool suggests officials are misinformed or confused about what they are doing.  That’s just more trouble.  

But it’s not hard to imagine.  Day One.  A directive that all travelers into the province must quarantine for 14 days is so broad and so general that it could have shut the province off entirely from everything.  Had it not been for the people who figured out the problem and alerted government officials to it- so they could amend their order – we’d have been royally shafted.

Same thing about travel within the province.  There is nothing to stop you legally from traveling to Clarenville from anywhere in the province to visit your aged mother who is living alone.  So, when someone asked the chief medical officer about mixing a bubble here and one in Clarenville, and she shot it down because of “unnecessary travel” we have to wonder if she has lost track of what is advice and what is an order. 

In this case, it was advice, even if it is coming from the chief medical officer.  Unless you are unfortunate enough to need to get on a government-controlled ferry to make your trip,  there’s nothing  - and there should be nothing at this point - to stop you from doing what you feel is necessary to make sure Nan’s roof doesn’t leak or help Pop sort out his diabetes medication with the local pharmacy.  If you know the risk and know the rules, then you can make a judgment call.  An informed judgment.

Going to the cabin instead of staying in town?  Not unnecessary travel at all if it keeps you isolated and lowers the risk of transmission of disease, improves your mental health, and allows you to work or do whatever you have to do. Yet the advice from government officials is that the rules say you cannot do that.

Let’s be clear.  There is *no* emergency order preventing you from going to the cabin and staying there.  Or checking to make sure it hasn’t been ransacked. But those simple facts didn’t stop the health minister from dismissing trips to the cabin as not merely frivolous but reckless.  Ordinarily that would be debatable advice.  It becomes part of a much larger problem though when people think advice – regardless of which official it is from – is more than that.

It’s not like officials aren’t aware of this.  Last week the chief medical officer said she did not want to get into the job of adjudicating all sorts of situations. Good on her for recognizing the danger of the issue but there are two issues that flow from this:  first, if people are looking for rulings, it means her orders and guidelines aren’t clear.  They aren’t and we’ll get to that in another post.  Second, both the CMO and the health minister should then refrain from offering opinions on situations that do not involve the application of actual orders.   

Yet they don’t.  What’s worse, last week, they issued an order based apparently on nothing but rumour. On Wednesday, Newfoundland and Labrador imposed a North Korea-like ban on people coming to the province.
What’s so striking about this move is that it came:
  • after the worst of the first wave of COVID-19 in this province passed weeks ago and hence risk is low,
  • travel is already reduced dramatically so not many are coming here anyway and again risk is low,
  • the whole thing was based on rumour - repeated without any evidence by CBC – that tourists exist, and
  • if that wasn’t all bad enough, even if they existed, there’s no evidence the tourists were breaking *any* laws or regulations.    

To make matters worse, no one from the provincial government offered *any* justification for it.  Not a shred of evidence, even as the Premier insisted, as he always has, that his government only practices evidence-based decision-making. They just carried on as if the unproven rumours were true.

Had they relied on evidence, it would actually show there is no problem at all.  There are no cases of CVD-19 on the Bonavista peninsula where the whole story started in the first place. The mayor of Bonavista says so in the CBC story linked above. Even if tourists are coming and violating the restrictions, they have not infected anyone at all. The correct action was a police investigation and a charge.  Instead, the government took an extreme action without evidence or justification.

We have come through the first wave of the COVID emergency with some good decisions and a great deal of luck.  No one should think, though, that everything is fine.  The bubbles decision and the others mentioned here are examples of problems with the way government has managed the response to this crisis. With the first wave largely behind us, we should fix those problems as we get ready for the possibility of a prolonged health emergency.