The recent Quebec Government’s extension of lockdowns and implementation of curfews to limit the spread of COVID-19 will have more harmful effects on the health and welfare of the population than benefits.
The purpose of this article written by a family physician, a business professor, and a lawyer, all based in Montreal, is to encourage the government and health care policymakers to reconsider the extension of lockdowns and the implementation of curfews and to focus instead on targeted protection based on scientific evidence, in order to improve the health and wellbeing of the population.
It is known that death from COVID-19 is about a thousand-fold higher in older people with multiple comorbidities than the young. Those who are not vulnerable should be allowed to resume life as normally as possible following safe public health measures.
According to a study in the Lancet on August 18, 2020 looking at the mortality rate in 50 countries ranked by the highest number of cases: “Full lockdowns, border closures, and high rate of COVID-19 testing were not associated with reduced number of critical cases or overall mortality.” Longer lockdowns led to higher death rates. Conversely, the longer the delays in implementing lockdowns led to lower mortality rates. The factors associated with the highest mortality included unemployment, obesity, and age.
In a review of 60 countries during the first 8 months of the pandemic published in the Frontiers in Public Health (November 2020), concluded that: “Stringency of the measures … to fight pandemic, including lockdown, did not appear to be linked with death rate.”
A World Health Organization (WHO) Writing Group, concluded that “forced isolation and quarantine are ineffective and impractical.” In October 2020 the World Health Organization’s special envoy on COVID-19 urged world leaders to stop “using lockdowns as your primary control method.” Small gatherings could be allowed with the usual precautions.
In a study published by the Center for Disease Control (CDC) in October 2020, there was an increase not only in COVID deaths compared to the previous year but also about 100,000 non-COVID deaths. In the 25-44 year-old group, which has an extremely high chance of recovery of COVID, there was a 26.5% increase in deaths in this group. Many of these deaths can be attributable to “deaths of despair.”
The American Medical Association in December 2020 released “Reports of increases in opioid- and other drug-related overdose and other concerns during COVID pandemic” and set out measures to deal with this crisis.
Moreover, an article in Bloomberg News in May 2020 showed that countries “with the harshest and most Draconian lockdowns suffered the most economically.”
Lockdowns and curfews limit rights and freedoms guaranteed by the Canadian Charter, such as: the right to liberty, the freedom of conscience and religion, the freedom of expression, the freedom of assembly and of association, mobility rights, the right to travel and the freedom from unreasonable search. In addition, economic rights have been violated.
For the lockdown and the curfews to be constitutional, there must be proportionality between the limit on our rights and the benefit gained. Based on the medical and scientific evidence which conclude to the limited effectiveness of lockdowns and curfews, we believe that the seriousness of the violation of these rights and freedoms is disproportionate with the benefits of the measures imposed by the government. The draconian limitations imposed by the Canadian and Québec governments have gone far beyond the justified and reasonable measures supported by science.
No scientific evidence supports that the recently imposed curfew will help decrease the rate of infections. In fact, “Quebec’s Public Health Director, Horacio Arruda, admitted he couldn’t provide data to show that a curfew can reduce COVID-19 infections, but he said that it sends a signal.” (The Globe and Mail January 7, 2021). Premier Legault called this “shock treatment”. Is it wise to administer a “shock treatment” to a population already mentally fragile after 10 months of deprivations?
In addition, people who need vital healthcare services have seen their right to life and security violated. A survey released on July 14, 2020 by the Canadian Cancer Survivor Network (CCSN) reveals that “the disruption of cancer care due to COVID-19 has triggered another public health crisis. In fact, more than half (54%) of Canadian cancer patients, caregivers and those awaiting confirmation of a cancer diagnosis report having had appointments, tests and treatment postponed and cancelled.” According to the same survey, “most affected by the disruption in cancer care during the pandemic are those awaiting confirmation of a diagnosis and recently diagnosed patients (74% and 73% respectively), who are at a critical time in their cancer journey.”
Rather than invoke authoritarian measures, we need to do more targeted quarantining for those who have contacted the virus. We need to continue to encourage and educate the public into following basic public health measures. We also need to protect people at higher risk who tend to be seniors who are fragile with chronic illnesses. For example, nursing homes should use staff who are vaccinated and not rotated and perform frequent testing of visitors. Retired people living at home should have groceries and other essentials delivered to their home. Visits should be limited to designated family members essential for their well-being but still maintaining sanitary measures.
Restaurants and other businesses should be allowed to reopen employing the best in viral safety measures. In fact, a few weeks ago Dr. Arruda, Quebec’s national health director publicly stated that Health Quebec had never recommended closing restaurants. The next day, Minister of Health Dubé declared that the government, not health services, had the last say in this matter. Arts, music, sport, religious services, and other cultural activities should resume with the same safety procedures in place. People who are more at risk should be encouraged to avoid participating as much as possible.
We need to prioritize protective measures, including handwashing, face masks, and social distancing, as prescribed by the CDC. We need to ramp up non-mandatory vaccinations against COVID-19. Vaccinations need to be ramped up also against influenza and pneumonia at the same time. We need to continue to care for those with regular health problems and continue to do standard screenings.
We cannot let the fear of COVID-19 shut down our lives, our society and our businesses. We must attack COVID with all our medical resources including medications, hospitalizations and ICU beds when warranted without causing collateral harm to those who can and need to work safely. Our population needs to be able to live, travel and buy safely.
For the long term, we need to rebuild health care capacity after many years of harmful cost-cutting measures.
Opinions expressed in this article reflect strictly those of the authors, not those of any organization for which they may work or be associated with.