Last week, testimony in the travel ban case by the province’s chief medical officer Dr. Janice Fitzgerald and epidemiologist Dr. Proton Rahman confirmed the extent to which decisions taken by the provincial government in the first wave of COVID-19 were *not* based on evidence and analysis.
This is extremely important reasons. First, it is emphatically not what the public
was told all along. To the contrary,
government officials – politicians and bureaucrats alike - insisted that they
were acting based on evidence and sound information.
Second, the testimony confirms the SRBP
post in June that government officials ignored available evidence in
managing COVID-19.
What really nails the point about decisions made by government officials without evidence is a series of presentations made by Rahman. Tom Baird obtained them through an access to information request in late June.
The ATIPPA disclosure confirms that Rahman and his
team started to look at actual local trends around the same time SRBP did in early
April. We know that Rahman and his group had the same
information SRBP used because it is *the first slide* in a presentation made to
the deputy minister of health on 13 April 2020. It’s the first time Rahman’s
team used this approach although, as with SRBP, they apparently started looking
at things this way some time before 13 April.
It shows, for
the first time in an internal government briefing, the number of active cases
instead of the number of cumulative cases.
Active cases show the number currently infected. Cumulative shows the number who ever had it,
even if they recovered. Active cases are
an important perspective because it shows progress during outbreaks. Cumulative cases always increase.
The 13 April briefing slide also means that Fitzgerald
had access to the same information as well as the analysis that showed the
effective transmission rate in the province was less than one after March
25. She also had data on the length of
hospital stays and the consistently low bed utilization rates both in hospital
and in ICU, all of which are accepted, international indicators for COVID
management. Fitzgerald was also aware the death rate in the province - another
crucial indicator - was far below expected rates. Despite the evidence,
Fitzgerald added additional restrictions starting with the ban at the end of
April.
And that’s the key point. Fitzgerald’s actions in
implementing the ban and apparently resisting efforts to lessen restrictions
were taken *despite* evidence.
There’s another big take-away and that’s the problems
with the way Rahman conducted his assessments.
It’s the same flaw contained in a paper recently published internationally
by Rahman but not yet peer reviewed.
The provincial government needed an operational
analysis of the type that has been commonly used since the Second World War to improve
performance in both the public and private sectors. Such an analysis - SRBP
used a rough version of the approach - would use local data to show the relationship
between existing measures and the disease trajectory. It would look at the strategy that was
supposed to be followed and compare that to actual events. An operational analysis would explain any
deviations from the strategy. Altogether,
an operational analysis would inform future planning by identifying what worked
and what didn’t work. It would allow
planners to predict likely demand for beds, ICU space, and personal protective
equipment.
Instead Rahman and his team disregarded local data
because it did not produce information needed to fit their model. It did not
fit their expectations and so the “Predictive Analytics” team continued
to quote wildly inaccurate forecasts based on irrelevant assumptions even as
events overtook the predictions.
The team also
presented “analysis” to government officials in a way that – while commonplace
in a university setting – was prone to mislead and misinform others lacking the
familiarity with the team’s methods to decipher them. Someone sitting through a briefing that
included complex-looking mathematical formulae or 50 cent and one-dollar words
instead of plain English would be hard-pressed to follow the argument or the relevance
even if, as seems to have not been the case, they had the slides in advance.
What’s worse, in the typical government briefing environment,
few people would wish to appear stupid or out-of-step by questioning a
supposedly expert-level presentation even though what they got was, for the
most part, jargon-addled piles of very preliminary or very basic data analysis with
very little useful information in it or interpretation applied to it. The result – not surprisingly - was a series
of well-intentioned but bad decisions taken by officials that were contradicted
by evidence. It also allowed Fitzgerald and others to rely on illusions when
making key decisions.
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