If you have the feeling that everyone around you is sick, and perhaps you're under the weather yourself, you're probably not imagining it. As part of our delightful post(ish)-pandemic normal, the damned virus, though much less deadly than before, is now circulating on an annual basis. It has joined the other nasty respiratory bugs that circulate in Canada in the fall and early winter; COVID's fall arrival seems to slightly precede the annual flu season. This is a mixed bag, in terms of good or bad. The good news is that not everything hits at once. The bad news is that our season of suffering seems to drag on forever.
I work mostly from home, but I have two kids in elementary school. Both are also in team sports. My wife is an elementary school teacher. There is no virus or germ circulating in this province that doesn't set course directly for my lungs. This fall hasn't been particularly bad for me; I've avoided any serious illnesses that have truly laid me up or caused me to miss any work. But it's definitely been a succession of, as history itself was once described, one damn thing after another.
My household is fairly young and generally healthy. These bugs, even when they come in waves, are nuisances. For the health-care system as a whole, though, they are aggregating into a real problem. The CBC's excellent Lauren Pelley wrote recently about the "new normal" of these overlapping waves of seasonal viruses, and noted the toll they are taking on a hospital system that has yet to recover from the pandemic. (And, hell, has probably actually deteriorated, in some ways.)
Lauren's work speaks for itself, and I'd encourage everyone to read it. Our hospitals are going to continue to operate under enormous strain for as far into the future as anyone can see. It is probably more realistic at this point to accept, both emotionally and pragmatically, that the health-care system, specifically the hospitals, will never go back to pre-2020 levels of baseline demand, at least during the fall and winter months. That will require building more hospitals, and then funding and staffing them, as well as tackling the long-standing issues regarding "alternate level of care" patients — those ready to leave hospitals but who remain there because backlogs in other parts of the system leave them with nowhere to go.
A larger hospital system, and also a more efficient one, aren't just things we can talk about anymore. We need them to head off further suffering and death. Whether or not we'll get them, who knows, but them's the stakes. We have become weirdly good at not doing the obvious and necessary things we need to do, so take nothing for granted and make no assumptions.
All I’d add to Lauren’s piece is something I’ve been encountering anecdotally while navigating the health system myself in recent months. (All our issues were relatively minor; I had the worst of it with a busted foot, which was unpleasant but nothing worse than that.) Hospitals remain an obvious challenge across the system, but the level of exhaustion I’ve seen among family doctors is setting off all kinds of alarm bells in what’s left of my brain the week before a vacation starts. We already know with certainty that a big part of why our hospital system is strained is because millions of Ontarians lack access to a family doctor: when sick or injured, even if their condition is fairly mild, these people often have no choice but to seek care at a hospital. Family doctors are scarce, walk-in clinics are often a fool’s errand. The hospital ER is often the only real alternative.
There are a lot of things that keep people on the job, and that’s as true for family doctors as much as anyone. But in casual chats I’ve been intrigued to hear how many people have been talking openly about leaving. Perhaps leaving the profession. More commonly, leaving their practice. Sometimes leaving Ontario or Canada entirely, seeking out better pay and working conditions in western provinces or, as keeps cropping up, the southern United States.
Most of these people probably won’t go. We all know the cliche about how many Americans pledge to move to Canada if the next presidential election doesn’t go their preferred way; most of them never try. It’s no small thing to uproot your entire life.
But it’s not an impossible thing, and if — as Lauren writes — we are indeed stuck in a new normal of higher rates of seasonal illnesses, and if our hospitals continue to be backlogged with all kinds of patients awaiting transfer to other facilities for further recovery, and if we start to lose some of our family doctors … none of this is good. The worse it gets, the more likely we are to see other professionals hit their breaking points and quit or move on, too. It’s not hard to imagine a kind of system-wide death spiral: each departure makes the next one a little more likely.
Canadians are proud of their health-care system. It’s a part of our national identity, in a way that is probably an unhealthy impediment to necessary reforms. We can’t ask people to stay in difficult, worsening jobs as a matter of national identity building. We need to make sure the jobs themselves are tolerable. The world we live in has gotten worse. The time to start offsetting that was actually years ago, but now would be the next best time to start.
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