Alone again: The cold logic behind the return of Manitoba's zero-visitation rule

A year ago today, Manitobans were rewarded with a daily COVID-19 case count of zero and the promise pandemic restrictions would soon disappear as well.

"We want to stay ahead of this virus and we do not want to start chasing it again," Premier Brian Pallister said on April 28, 2020, when the first wave of the pandemic was receding after claiming a total of six Manitoban lives.

One year, two more waves and 962 deaths later, we are still chasing the virus known as SARS-CoV-2.

And the most restrictive of restrictions returned while most of us were sleeping: Manitobans are no longer allowed to socialize at home with anyone they don't live with, unless you happen to be single or consider stilted small talk with the furnace-repair guy or Amazon delivery lady a form of meaningful social interaction.

The ban on household visitation is the most powerful measure in a suite of new restrictions aimed at ending the exponential growth in COVID cases than began in Manitoba after April Fools' Day.

On April 2, the seven-day average daily case count in Manitoba stood at 53. On April 27, it had risen to 224.

The primary reason for this rise is variants of concern, which are more contagious and as a result, more difficult to control.

A temporary new norm

In recent weeks, public health officials have blamed play dates, parties and sleepovers for part of the rise in cases. The reality is any form of indoor contact is a good way to transmit the virus.

The more contagious variants are simply better at jumping from person to person indoors, regardless of what the people happen to be doing.

Hence the return of the unlikable but effective no-visitation rule, which was the main weapon wielded by public health authorities as they tried to staunch the vicious second wave of COVID-19 from late November to early January.

On Monday, when Chief Provincial Public Health Officer Dr. Brent Roussin announced the return of the no-visitation rule, he described efforts to effectively create a temporary social norm.

"It should be unusual to see people visiting private residences. If we had outdoor groups of, say, 10 at private residences, it wouldn't be unusual to see three cars in someone's driveway," Roussin said.

"The uncontrolled areas, that's where we're seeing the transmission, so we want people to stay home, not have any visitors over at their place right now." 

Given that the vast majority of Manitobans are reasonable and logical, it is logical and reasonable to expect most to put up with four more weeks of government-imposed isolation.

It's easier to forgo visitors on a sunny afternoon in May than it is during a dreary December deep-freeze. It's also easier to hold out hope for the future when upwards of 8,000 coronavirus vaccine doses are going into arms every day.

"Everyone's tired of these restrictions, but this could really be our last push, with vaccines rolling out and some more on the way," Roussin said.

Why a patio but not a yard?

What is less easy for Manitobans to understand is why they can't have any visitors in their yards or on their stoops while restaurant patios remain open.

Roussin tried to explain the apparent disjunction on Monday.

"The patios are very limited. They're also controlled," he said, referring to the maximum table size of four people, two metres between tables and most of all, the requirement that restaurants collect the names and phone numbers of everybody out for a plate of chicken wings and a pitcher of beer.

The theory at work is when people go out, they tend to abide by rules because restaurants are applying them. Patio-goers do not have to police themselves.

In a private residence, people are far less likely to monitor their own behaviour, either in terms of the number of people they see or the distance they keep from them. 

It's also far less realistic to expect people to remember everyone they socialize with in a private residence — not to mention when and precisely where — than it is to expect a front-of-house manager to carry around a clipboard full of lined paper.

Yes, most people follow rules, especially when those rules are aimed at preventing hospitals from filling up with oxygen-deprived patients. It's just that few people believe the rules apply to them in every instance.

The Pallister government may have annoyed fewer people had it also closed down patios. But that would have removed another socialization option at a time when the options are limited to going for walks or gathering in parks.

It is more difficult to explain the decision to wait three-and-a-half weeks after cases started to rise to enact tougher pandemic measures. On Monday, both Roussin and Pallister insisted Manitoba's case trajectory only became apparent over the past few days.

"It's hard to make rules based on hindsight," Pallister said.

Pandemic decisions are indeed difficult to make. Politicians and public health officers must choose between competing benefits and harms. 

But it is reasonable to expect decision-makers to engage in some form of pattern recognition, when April case growth starts looking like October.