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Five years ago this week, the World Health Organization declared the coronavirus outbreak a pandemic, warning that the situation would worsen for countries around the world.
“We expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher,” WHO Director-General Tedros Adhanom Ghebreyesus said at the time.
Canada had already reported 1,360 cases by March 12, 2020. In a matter of days, governments closed schools and told travellers to self-isolate, the House of Commons shut down and borders were closed to most travellers.
Five years later, COVID-19 is in the rear-view mirror for most Canadians. Yet its effects live on, and they continue to have an impact on the health of Canadians. Here’s how.
Effectiveness of Canada’s pandemic measures
The initial months of the COVID-19 pandemic brought stay-at-home measures to protect our health and Canada’s health-care systems from the effects of the new virus.
“It is the Canadian public that suffered through those public health measures, but they were very effective,” said Dr. Fahad Razak, an internist at St. Michael’s Hospital and a professor and research chair at the University of Toronto.
“There was one very important notable exception, which is long-term care,” said Razak.
Canada had the second-lowest mortality rate after Japan, Razak and his team reported. The country also had the highest vaccination rate for two doses of the vaccine between Feb. 4, 2020, and Feb. 8, 2022.
By December 2020, after the second COVID wave had passed through the country, more than 15,000 people had died, according to Statistics Canada.
Razak’s team estimated 70,000 more Canadians would have died, if Canada’s vaccination and death rates had been similar to those in the U.S.
“That means that probably most of us would personally know someone who is alive today, but would have died if we had had the infection rates and the death rates that the United States had,” Razak said.
As in other countries, deaths in Canada disproportionately occurred among front-line workers, such as meat-packing plant labourers, compared with those who worked from home.
But Canada had one of the highest long-term care mortality rates of any comparable G10 country, Razak said. Overcrowding and problems with staffing contributed to the excess deaths, he said.
“Those deaths of vulnerable senior citizens remain a blot on Canada’s COVID-19 record,” said Dr. David Naylor, who co-chaired the federal government’s COVID-19 Immunity Task Force.
When vaccines became available in December 2020, they were rolled out to long-term care staff and residents, and other vulnerable populations.
“Not only was vaccine uptake phenomenally fast, Canadians also were assiduous about the use of masks given belated recognition of the airborne nature of COVID’s spread,” Naylor said in an email.
While Naylor credited Canada’s early success to front-line clinical care and public health, “in my view, the unsung heroes of the pandemic were Canada’s citizens.”
— Amina Zafar
Highlighting problems in long-term care
One of the most enduring symbols of the pandemic was the impact it had on people living in long-term care homes.
According to data collected by the National Institute on Ageing, more than 17,000 people died from COVID-19 in long-term-care settings during the first two years of the pandemic.
Peter Wheeland saw it first-hand.
“COVID was just the signal that we had serious problems in our health-care system,” he said in a recent interview. “It virtually collapsed.”
His parents lived at the Herron long-term care home, west of Montreal, when the lockdown began. Harrowing stories emerged of seniors left alone, underfed, in soiled diapers. A severe shortage of staff and protective equipment led to a deadly outbreak of COVID-19.
Wheeland’s father moved to another home, where he died from the virus. His mother’s case was mild, but her experience at Herron was deeply troubling for her son.
Scenes like this played out in several long-term care homes across the country amid staffing shortages, insufficient infection control and a virus that was particularly deadly for the elderly.
Five years later, some say that while there have been changes, gaps in long-term care remain.
Quebec instituted a training and hiring push for orderlies and an accelerated program for nurses to boost staffing.
The Ontario government says it invested billions to add new beds and hire more staff.
Samir Sinha, a geriatrician at Sinai Health in Toronto, was part of a group of experts who developed national long-term care standards for the federal government.
“There’s still a lot more work to do,” Sinha said. “Thinking about how we build long-term care homes of the future, how we staff them.”
The National Association of Federal Retirees in Ottawa is pushing for federal legislation to ensure national standards are widely applied.
Sophie Zhang, a family doctor who works in long-term care in Montreal says despite improvements like better infection control, staffing remains a top concern.
“The tragedy of COVID and long-term care was the fact that we were not able to give basic care that people needed,” said Zhang.
She said long-term care homes need contingency plans for staff shortages and improved working conditions to prevent another tragedy.
— Alison Northcott
Faith in public health eroded — but it can be restored
It started with solidarity.
Canadians banged pots and pans in support of health-care workers. We stayed home.
We watched grim figures climb daily: the number of dead, hospitalized and infected — a macabre reminder of the gravity of the situation.
Provincial governments put in place unprecedented public health measures: vaccine passports across most of the country, as well as mask mandates. We stayed inside — in Quebec, following a curfew.
It felt like we were fighting a war against an enemy we didn’t understand and couldn’t see. But we were all in it together.
Then it all changed.
Somewhere along the way, some Canadians started thinking the people tasked with caring for us were the enemy — not the virus.
A vocal group of Canadians parked outside Parliament Hill for months, protesting against health measures they saw as tyranny. Public health officers — once far from the public eye — faced threats and harassment, as did overworked doctors, nurses and paramedics, toiling in crammed emergency rooms, intensive care units and ambulances here and abroad.
The pandemic changed the way some Canadians look at — and trust public health officials. Those who work in health care and/or offer support to people dealing with social polarization say there will be a long-lasting impact.
While most still trust their family doctors, trust in public health officials has eroded since the beginning of the pandemic, says Samuel Veissière, an anthropologist and cognitive scientist at the Université du Québec à Montréal, who researches polarization and radicalization.
“There’s a smaller but significant — and growing — segment of the population that just does not trust any public health messaging anymore,” he said.
“There’s also been an alarming rise in adherence to conspiracy theories, or to different kinds of alternative and quack medicine.”
At least three times as many people as before the pandemic are coming into the Montreal polarization clinic where Veissière works. The clinic helps individuals and families dealing with the psychosocial consequences of radicalization, such as isolation from family. Not only are more people subscribing to conspiracy theories, but Veissière says the profile of those who are most at-risk is also changing.
“We see that younger and younger people subscribe to conspiracy theories.”
But some are cautiously optimistic that public health officials can successfully fight misinformation — especially, since we learned so many lessons about health messaging during the pandemic.
“I think trust can always be regained, but boy, it’ll take a lot of work,” said Dr. Donald Vinh, an infectious disease specialist at McGill University Health Centre.
Vinh says health messaging needs to be as straightforward, honest and empathetic as possible. During the pandemic, he says, other factors sometimes got mixed in, to the detriment of public health.
“It became a confused message of science, with politics and other factors mixed in.”
Also key, he says, making sure people understand science changes and evolves; and acknowledging disparities should they arise.
“We can’t deviate or forget about those lessons and that playbook when the next outbreak occurs.”
— Jennifer Yoon
COVID vaccines paved the way for new therapies
When the pandemic began in March 2020, few believed there would be a vaccine within a year. But it was, in fact, a scientific achievement decades in the making — and one that could have a ripple effect long into the future.
Two of the three COVID vaccines now available in Canada were developed using a platform called messenger RNA or mRNA. They work by sending a set of instructions to our cells: here’s what a coronavirus spike protein looks like, so our bodies can recognize and destroy the intruder.
Two scientists, Katalin Kariko and Drew Weissman, won the Nobel Prize in physiology or medicine in 2023 for their work on mRNA biology and finding a way to deliver mRNA into our cells.
“The COVID pandemic really opened our eyes to the uses of mRNA vaccines,” said Alyson Kelvin, a virologist and vaccinologist at the University of Calgary. Because mRNA vaccines can deliver genetic information directly to cells, scientists believe they could be used to prevent or treat a variety of conditions from influenza to cancer.
There is already an mRNA vaccine for respiratory syncytial virus (RSV) for people 60 and over. An early phase clinical trial of an experimental mRNA vaccine for pancreatic cancer has also recently shown promise.
There’s even hope that mRNA technology could treat some genetic diseases.
“The mRNA vaccine technology holds the promise to be able to deliver the message required to make an enzyme they are born unable to make,” said Vinh, the infection disease specialist at McGill University Health Centre. “That would be life changing for all the people who are affected.”
But mRNA technology won’t render all other vaccines obsolete. Some, like the tetanus shot, are so safe and easy to manufacture, they won’t be changed. But for Vinh and others, the promise of vaccines that can fight a range of illnesses is exciting.
“We’ll be able to identify these threats to human health, define what the challenges are in terms of a solution, and then come up with an answer to those challenges.”
— Marcy Cuttler
How prepared are we for the next pandemic?
Five years after the start of the COVID-19 pandemic, Canada is still at least a year away from finalizing its strategy for dealing with the next pandemic.
The Public Health Agency of Canada says it expects to complete a new pandemic preparedness plan in 2026. The agency is developing the plan together with provincial, territorial and Indigenous partners along with outside experts.
The officials designing that plan have plenty of lessons from which to draw.
“One of the most useful things that COVID-19 did for us is to show us where our vulnerabilities lie,” said Dr. Matthew Miller, scientific director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University.
In particular, he says the tragedies that unfolded in long-term care homes show that public health measures to protect vulnerable people are absolutely crucial.
The early days of COVID provided real-time evidence about the effectiveness of measures like physical distancing and masking in slowing the spread of the virus at a population level. But the uneven and at times chaotic implementation of those measures undermined public trust in the benefits.
Miller is calling for a shift in the focus of pandemic preparedness planning.
“There’s been, in my view, disproportionate emphasis put on developing systems and infrastructure to increase the speed at which we respond to future pandemics,” he said. “We need to be way more focused on preventing pandemics than responding to pandemics.”
Stopping the next pandemic before it starts may be easier said than done. Scientists are warning that H5N1 bird flu has the potential to become a pandemic and are calling for “urgent action” to address gaps in preparedness.
Miller argues prevention is possible by taking effective measures targeting where pandemics begin: places where humans have the most interaction with animals, particularly in agriculture.
— Mike Crawley
