What Alberta got wrong — and right — on COVID-19

Putting all responsibility on individuals hasn’t worked.

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Even after a year, the pandemic doesn’t feel “normal.” But it’s easy to forget that these massive disruptions were hard to imagine not that long ago—even though experts had warned for years that such an event was inevitable.

There’s no way to grasp the scale of the human impact. Every death, every job lost, every business closed represents not one affected person but many. Over 1,900 lives have been lost so far in Alberta, but millions of lives have been changed—many of them forever.

When the novel coronavirus was first spreading, governments had to take action while scientists were still figuring out the characteristics of the virus in real time. Now that we have a year of data, policies and results to compare, we can look back and see what Alberta got right, and where it went wrong.

In the beginning

Alberta’s initial response was in step with the actions of other provinces. In a span of ten days beginning March 12, every province invoked emergency powers and introduced restrictions to curb the virus’s spread. Alberta’s announcement came March 17, making it one of the first provinces to act.

“We really did see a quick response in March, and I think that was probably because they thought it would be short,” said health policy expert Lorian Hardcastle, an associate professor in the University of Calgary’s Faculty of Law.

“It’s hard to find fault in the first wave [response].”

When Premier Jason Kenney invoked the public health emergency on March 17, there were 96 cases in Alberta. Three months later, when the government let the emergency expire and lifted many restrictions, there were 440 active cases and 151 people had died.

Health minister Tyler Shandro said at the time that it was “an important day for our province… The state of emergency is no longer needed to protect Albertans.”

That was last June; 1,781 people have died since then.

By mid-July, the number of daily new cases was back in triple digits. By November, it had surpassed 1,000 for the first time.

On November 15, Kenney insisted in an interview that restrictions were not the answer. “We’re not going to enforce our way out of this, we’re not going to turn Alberta into a police state,” he said.

Nine days later, on November 24, the provincial government introduced another public health emergency and new restrictions.

But these fell short of what many experts were calling for. A group of 70 Alberta physicians had recently issued a public letter in favour of a two-week “circuit breaker” of strict restrictions to counter the rising second wave.

Under pressure, Kenney introduced stricter measures two weeks later on December 8, including the first provincial mask mandate.

“I think their response to the second wave in the fall was much weaker,” said Hardcastle.

Since health is a provincial jurisdiction, each province and territory has taken their own approach to the pandemic. But while scientists were learning about COVID-19 on the fly, there are well-established best practices in public health for dealing with an infectious disease.

Michael Schwandt, a medical health officer with Vancouver Coastal Health and a clinical assistant professor of public health at UBC, said the primary objective is to prevent close contact to limit the spread of the virus.

“One could readily think of policy interventions to do that,” he said. “It’s not particularly mysterious, some of the ways we might go about preventing the spread early on,” such as banning mass events or social gatherings.

But putting all responsibility on individuals to obey public health orders is a faulty approach.

“We’ve learned that it’s not enough to give instructions to workplaces or individuals on how to prevent transmission, but supporting people to do so is important too,” said Schwandt. People who are under-housed or living in crowded housing, for example, will have a difficult time avoiding close contact.

“That’s not a matter of virology but the social conditions we have.”

How Alberta compares to B.C.

With a year’s worth of data, the numbers tell a story.

There are several metrics to consider.

We lead the country in per-capita tests. On a per-capita basis, Alberta ranks second-worst nationally both in active cases (behind Saskatchewan) and total cases (behind Quebec), and fourth-worst in deaths. For stretches of the past year, we’ve led the country in new cases per capita.

Of course, direct comparisons between different jurisdictions is difficult. Alberta’s closest analogue in confederation, at least in terms of numbers, is probably its neighbour to the west.

British Columbia has 5.1 million people, half of whom live in metro Vancouver; Alberta has 4.4 million people, half of whom live in either Calgary or Edmonton.

But in the pandemic, the numbers diverged. B.C.’s cases per capita are about half of Alberta’s.

In deaths per million, Alberta is fourth-worst in the country; B.C. is sixth, but our rate is 80% higher than theirs.

There isn’t one single element or policy that explains those very different results. But while both provinces eased restrictions last summer, B.C. reintroduced them in October, more than a month before Alberta did the same.

Speaking about B.C., Schwandt pointed to the avoidance of “dramatic swings” in restrictions as an important approach.

Since B.C.’s initial easing of restrictions last May, “there’s been more a sense of tweaking our controls… making specific adjustments to the transmission that we’ve seen, rather than a sense of a black-and-white ‘open’ or ‘closed’ approach.”

Hardcastle also noted the difference not just in what the respective governments did, but how they did it.

“One thing they’ve done really well is this hasn’t been as political in B.C. as in other provinces,” she said. “That does help with compliance and public trust when it is a de-politicized issue.”

Politicizing the communication

Albertans are a diverse group in terms of background, culture, political views, and media diet. Because a massive public health emergency requires that disparate populace to cooperate together, it’s critical that government communications be clear, consistent, and as apolitical as possible.

[Alberta] wasted time and public good will pushing an app that… was never going to work

Susan Erikson,

Health sciences professor, SFU

“I think when political leaders involve public health experts as honest brokers in the process and in communications, it does increase trust and uptake of the messages,” said Schwandt.

It’s hard to argue that the UCP met this responsibility.

From lecturing racialized communities, to issuing confusing public health orders, to slow and tepid condemnation of anti-mask rallies, to initially giving a pass to MLAs who travelled abroad, the UCP’s communication during the pandemic could charitably be called erratic.

Hardcastle said the overall effect was confusion and politicization of the pandemic response.

“There was a failure to denounce the rallies from Premier Kenney and other officials, because sometimes the people at those rallies are their base,” she said.

“We’ve seen a ton of blame in terms of the federal government’s role in procuring those vaccines, and it isn’t necessary. It doesn’t do anything, it doesn’t help anything, it’s solely for the purpose of criticizing the federal government.”

These actions give the impression that the government’s public health decision-making is political rather than strictly based on science. Once that impression has been made, people might not take the government’s orders and advice as seriously as they would take a doctor’s.

The UCP’s insistence on defending its largely discredited COVID-19 tracing app when the federal government’s superior app is available also falls in the category of politics over practicality.

Susan Erikson, a health sciences professor at Simon Fraser University, has studied the use of mobile phone technology during pandemics. In an article last year, she argued that “[t]he best governors make decisions that decrease suffering, grief, and risk of death for the largest number of constituents possible, prioritizing the needs of the people most vulnerable and least able to provide necessities for themselves.”

Comparing Alberta and B.C., Erikson said in an email that the former “wasted time and public good will pushing an app that—had the government checked in with social scientists ahead of time—was never going to work. B.C. did not hard-sell app silver bullets, and invested in contact tracing instead. Good choice.”

The fact that the public health restrictions were often confusing enough to require clarification also reflects poorly on the government.

“It’s a basic tenet of democracy and law-making that laws are clear so you can know what your obligations are,” said Hardcastle.

It was also unclear whether rules would be enforced. The tempered response to anti-mask rallies and the belated crackdown on a church continuing to flout regulations communicate a message to everyone watching the government’s actions, said Hardcastle.

“That shows the public that they may not be serious about enforcement: these people don’t have to comply, why should I?”

Lives versus livelihoods

The economic toll of the pandemic has been a consistent focus of the UCP. Protecting both “lives and livelihoods” is a framing so beloved by the party that they not only use it as a talking point about the pandemic, they also made it the tagline for the budget.

“I think it’s wrong to think of them as isolated things,” said Hardcastle. “A quicker, harder shutdown of the economy can often be a shorter shutdown.”

The thinking from the conservative, free-market party may have been that, if businesses can stay open, government won’t have to spend as much to support them.

One example of enabling private enterprise at the expense of public safety stands out.

When the Cargill slaughterhouse in High River produced the largest single-facility outbreak in North America, it shut down for two weeks before reopening and sending employees back to work. The move was sanctioned by Alberta Health Services, Occupational Health and Safety, and the province’s chief medical officer, Dr. Deena Hinshaw.

Nearly half of the 2,100 workers tested positive for COVID-19. Kenney refused to keep the plant closed for longer. (The plant has recently had a new outbreak; the RCMP have launched an investigation into one of the deaths, and a class-action lawsuit may be coming.)

Inevitably, when you lift restrictions, numbers go up.

Lorian Hardcastle,

Assoc. professor of health law, ucalgary

The Cargill plant, which is owned by the United States’ largest privately-held corporation by revenue, is largely staffed with recent immigrants or temporary foreign workers, many of whom speak little to no English.

Schwandt noted that the pandemic has highlighted and exacerbated many long-standing social inequities.

“We’ve seen what an issue housing has been, what an issue transportation has been, what an issue culture and language have been in terms of accessing health services,” he said.

“I hope we learn the impacts that social determinants of health had on this pandemic and improve on them—hopefully before the next pandemic, and for the benefit of health in general.”

The road ahead

Given that Alberta is the most anti-vax province in Canada—one in five say they will never get a COVID-19 vaccine—the messaging from health officials is even more important to convince those still on the fence.

“Those people are up for grabs,” said Hardcastle. “The government can convince [some of] them and they need to be doing that.

“If I’m Premier Kenney or Minister Shandro, and I have air time to talk about vaccines, I’m not spending that time blaming Trudeau” or expressing surprise at federal vaccine approvals.

After a year of pandemic life, most people are not looking backward but forward: toward vaccination, the lifting of restriction and the return of social life.

The provincial government has fuelled those hopes with pledges that it will get Albertans vaccinated quickly. But all is not well just yet.

Alberta’s daily rate of new cases has fallen significantly from its peak in December. But our current 7-day average of new cases is higher now than it was during the peak of the first wave. Hospitalizations are still high. Variants of concern are spreading quickly.

Warmer weather means people will be more likely to gather outdoors. But with widespread vaccination on the not-too-distant horizon, some might be tempted to disregard pandemic precautions before it’s safe to do so.

“I do think that as we open, yes, cases are going to go up again,” said Hardcastle. “Inevitably, when you lift restrictions, numbers go up.”

To reach the end of the pandemic quickly and safely, Albertans will need to trust the advice of government officials.

But whether those officials have done enough to earn that trust is a question worth asking.

Taylor Lambert is The Sprawl's Alberta politics reporter.

CORRECTION 03/15/2021: The original version of this story incorrectly stated the number of COVID-19 deaths in Alberta since the first public health emergency ended. The correct number as of the publication date is 1,781. The Sprawl regrets the error.

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