B.C.’s first confirmed case of the novel coronavirus was announced in late January. Since then, the province has had around 2,800 cases of the disease.
But B.C.’s infection rate, at 55 per 100,000 people, pales in comparison to Ontario, which has had 226 cases per 100,000, or Quebec’s which sits at 641.
So what’s led to B.C.’s relative success so far during the pandemic? Experts say it’s likely due to a few things.
Something as simple as the timing of March Break may also have had something to do with how many cases a province saw, said David Buckeridge, a professor at the McGill University School of Population and Global Health. The March Break period was relatively early in Quebec, and people travelled and came home before many restrictions were in place, possibly carrying the virus with them.
These small events matter early on in a pandemic, he said, as a handful of cases can quickly multiply.
Looking at Montreal, which was especially hard-hit, the first neighbourhoods reporting cases were “in communities where there’s been a large number of imported cases from travel to Europe or the U.S. East Coast,” he said.
The locus later switched to other neighbourhoods, but these travel-happy people drove the epidemic early on.
But luck and timing isn’t the whole story. Data recently released by the B.C. government showed that most of its cases also came from Europe, other parts of Canada, and from Washington state, not from travellers coming from Asia.
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But because of B.C.’s strong connection to Asia, the province was on top of testing, said Peter Berman, director of the School of Population and Public Health at the University of British Columbia.
“They were very, very quick off the mark to take advantage of the publication in China of the genetic composition of the virus and to develop tests locally that could be produced and used locally,” he said.
“And when you are working with an outbreak that is kind of initially modest in its size and spread, you can much more successfully use the classic public health measures of testing and tracing.”
In Quebec, massive outbreaks in long term care facilities contributed to the province’s high case numbers and death rates, Buckeridge said. Policies like allowing staff to work at multiple facilities just facilitated the virus’ spread in vulnerable populations, he said, and it was allowed for a long time. B.C. issued an order in March to stop this, although it took some time for the practice to end.
And then there’s Dr. Bonnie Henry, the provincial health officer of B.C.
“She’s, I mean, just an exemplar of what you would want in a medical officer of health,” said Dr. Gerald Evans, head of the division of infectious diseases at Queen’s University’s medical school.
Berman echoes the sentiment. “Very early on, we had this effective spokesperson,” he said.
But while he likes her work, she doesn’t deserve all the credit, he said. The health system in B.C. is set up to support her.
“She had both the technical and personal skills, but also the institutional and organizational backup,” he said.
In a big province like Ontario, the health system is very complex and multi-layered, Evans said. As he works in his hospital in Kingston, Ontario, “It is amazing to see all of these edicts coming down. And they’re coming from the premier’s office. They’re coming from the Ministry of Health, from the Ministry of Long Term Care.”
He’s often unclear which are requirements, which are suggestions, and who is doing what, he said.
According to Berman, the B.C. health system is a little more streamlined.
Provincial health officers’ roles and powers also vary province by province, he said, pointing to a study comparing the different laws. B.C.’s provincial health officer is mandated to advise the government in an independent manner, can make reports directly to the public, and can order people to take preventative measures in an emergency.
This isn’t the case everywhere in Canada.
Plus, according to Berman, in B.C., politicians largely kept their noses out of the public health conversation, letting Henry lead the message.
“I was particularly struck by the way, here in British Columbia, that the politicians let her do her job. You know, she was the spokesperson.”
Evans agrees. “I think what B.C. did is, the politicians, I think they kind of parked their egos and said, we’re going to let a very competent, well-informed person sort of handle it.”
Anywhere in the world where politicians have dominated the conversation, “it goes right off the rails,” he said.
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