Why B.C.'s containment and recovery from COVID-19 is going smoother than Ontario's

At the end of a news conference Tuesday, B.C. Health Minister Adrian Dix seemed to reference the troubles Toronto was facing during this stage of the response to the pandemic.

"The past few days have offered some images from other jurisdictions, where efforts to stop the spread appeared to have paused," said Dix. 

"These images can make it seem like others have drifted." 

It was hard to imagine Dix wasn't talking about the now infamous photos of people crowded in Toronto's popular Trinity-Bellwoods park.

Those pictures gave an image to the struggles Ontario has had in reducing positive cases and transitioning to its restart stage, a contrast to what's taken place in B.C. over the past month.

Over the past seven days, Canada's westernmost province announced 84 new COVID-19 cases, continuing a steady week-over-week decline since late March.

In Ontario, over the same period, there were 2,807 cases. 

Some of that can be explained by testing and population volumes, but even when adjusted per capita, it's a tremendous difference.

Epidemiologists say there are likely a number of reasons for that divide. 

Public health over politicians

The reasons Ontario suffered more than B.C. during the initial containment phase are complex — and include an element of luck — but it also made the province's recovery more difficult.  

"Ontario got hit with more cases early than B.C. did, and I say that not to be defensive, but it made the job harder," said Dr. Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto.

"B.C. had the wind at their back in terms of not having the same volume … but I don't think that's the main story here."

Furness said it appeared B.C.'s policies and daily messaging were being driven by public health experts, while in Ontario they appeared to be driven by politicians.

"I don't find any evidence that we've got a strong epidemiological voice [at the table] saying this is a good idea and that's a bad idea," he said.

"In B.C., [Provincial Health Officer] Bonnie Henry is famous, at least across the country now, as the expert who really is an expert, who really can answer those questions and is clearly involved in decision-making."

Furness also said Ontario had suffered by having several different people — both health officials and politicians — act as the lead spokesperson, focusing on different hot button issues of the day, often with changing advice. 

That, he said, could contribute to an overwhelmed and skeptical public. 

"It's firefighting. It's playing whack-a-mole," he said. "It erodes trust, it erodes public confidence, and that's really damaging."

Us and we, not you and I

Raywat Deonandan, an epidemiologist and science communicator at the University of Ottawa, said there were a number of reasons Ontario had suffered, including beginning its restart strategy before active cases significantly declined, failures in slowing down the spread in care homes, and a lack of effective contact tracing for people who have contracted the virus.   

But he agreed that the overarching issue was an inconsistent message overly shaped by politicians. 

"There isn't a single voice. There isn't a clear message," he said. 

"Obviously economic considerations are important and public demand is important, but I sense that the decisions in B.C. are a bit more informed by public health than the decisions in Ontario."

For his part, Dix didn't reference any policy differences when talking about the challenges "other jurisdictions" faced. 

But at a time when Ontario's debate is focused on what individuals shouldn't be doing — i.e., crowding into parks — it was noteworthy that Dix's message focused on what people, as a collective, continue to do. 

"This is our B.C. pandemic, our B.C. effort, and our B.C. path to safety," he said during a two-minute speech where he said the word "our" 12 times.

"It's a response that saw all of us, each one of us, make a difference to build our own future."