'You don't copy the losers,' says doctor pushing 'COVID-zero' strategy

Dr. Andrew Morris is calling on Canada to implement an "aggressive" national strategy to replace the country's surging COVID-19 numbers with a single digit — zero.

Morris is an infectious disease specialist at Toronto's Sinai Health System and University Health Network. He says skyrocketing coronavirus numbers in multiple provinces are proof that Canada's piecemeal approach to the pandemic is doomed to fail. 

He's one of several health-care professionals across the country calling on officials to implement whatever measures it takes to reduce transmission and infection rates to nothing at all. They're calling it "COVID zero." It's an idea that Morris says his colleague Dr. Irfan Dhalla proposed back in May. 

Here is part of Morris's conversation on Monday with As It Happens guest host Nil Köksal.

Dr. Morris, for those hearing the phrase "COVID zero" for the first time, what do you mean by that?

Setting a clear target for where government, public health officials and the public should be aiming for, which is to get as close as possible to zero cases and zero community transmission.

What do you think it would take for Canada to achieve COVID zero?

I think it would take initially quite a substantial effort, and it would take a cohesive effort that would require some hardship up front. I think it would be misleading to state otherwise.

But it would also require serious investments at all levels of government and public health to get an aggressive test[ing], contact tracing, isolating and support system in place, and also putting plenty of effort into supporting, really, all people. That includes business owners and their employees, and, really, anyone else who might suffer from pursuing a COVID-zero strategy.

Fight against COVID-19 full of half measures, doctor says

4 years ago

Duration 6:48

Dr. Samir Sinha is among a group of medical professionals who have taken to social media to urge the Canadian government to implement a #COVIDzero strategy because, they say, measures taken to control COVID-19 have not been effective enough.

Do you think a complete lockdown or something similar to what [many provinces] had back at the end of March/April … is that what needs to happen right now?

I'm not sure we need a complete nationwide lockdown. What we really need to have is a discussion about trade-offs. What we unquestionably need to do in many places around the country is to drop the number of cases [by] a really substantial level. There are two main ways to do that.

One is to be, I'm going to say patient, but that's probably not a good term, and be less aggressive. And [we] would have a slow decline in cases, if at all. I think in many jurisdictions we've tried to do that ... and we've actually failed in being able to halt the rise in cases.

On the other hand, we can address this aggressively. And the more aggressive we do so, the more rapid the decline in cases. And what we really need to do is get the cases down to an extremely low level, after which we'll be able to manage them very effectively.

There are [economic] concerns, as always, when we talk about shutdowns, full or partial…. How do they mitigate the economic concerns?

I think the first thing we need to understand is that not doing this actually has probably broader economic concerns. What countries who do this have achieved is no foreseeable future third wave — or in some places, no foreseeable second wave.

We're in the midst of our second wave, and the ultimate goal is to avoid a third wave. And really any other approach other than trying to target towards zero is going to inevitably result in a third wave.

So the economic cost, if we're talking about the cost to businesses, the challenge of businesses having uncertainty about opening and closing, all these costs are greater when you don't work towards getting the caseload down substantially so that you avoid any future waves.

I'm certain every premier and every public health official would agree that zero transmission is the ultimate goal. What do you think is holding them back?

I think there's a couple of things. One is, even though they may have that as a hidden goal, I don't think there is a single government in the country who has articulated that as a goal. And on top of that, I would say that because they haven't articulated it as a goal, we haven't pursued that goal. And we've tolerated, in my mind, fairly unacceptable levels of transmission, especially over the late summer months and early fall. And that's really resulted in where we are today.

You're not going to be a winner if you follow the losers. You go and try and replicate, or at least figure out, what the winners do. And right now, we're pursuing a losing strategy.- Dr. Andrew Morris, Sinai Health

We're seeing rising case numbers across the country. What is the message people at home who are listening maybe are not getting?

I'm not sure that the public hasn't gotten the message about how we need to halt the transmission. I think for a lot of members in our communities, it's challenging for them to be able to follow the best guidance. Either they have difficulty staying isolated, they can't avoid being in congregated settings, or they have financial challenges that they don't feel that they can avoid. 

And that's why a COVID-zero strategy that really puts all our resources in helping people overcome all the obstacles they would normally encounter to really following best public health practices in the short term would, in the long term, result in all of us being more free.

So you think the messaging hasn't been clear enough?

I don't think I'd be alone in saying that most of the public is somewhat confused in terms of what's expected of them on a day-to-day basis.

What's going to happen if governments don't take your advice?

I'm assuming you've followed the news in Europe? ... Well, that's what's going to happen.

So you're talking about repeated waves unless we get a handle on it?

It's unquestionable. We're following the exact blueprint of most other high-income countries, certainly all of them in central and western Europe, and the United States as well. And, you know, I'm a sports coach. And the one thing I've learned over time is you don't copy the losers because you're not going to be a winner if you follow the losers. You go and try and replicate, or at least figure out, what the winners do. And right now, we're pursuing a losing strategy.

Which winners? 

New Zealand, Australia, Thailand, Vietnam, South Korea, Hong Kong, Taiwan, Atlantic Canada. There's more. It's not a tiny list. And each of them have their own challenges, but they've been successful.

As premiers continue to give their message to people across the country, what do you want to say to those premiers?

What I'd love for them to do is to get together and at least have a shared vision. I think Canadians deserve our best chance at battling this before we have the rollout and implementation of an effective vaccine. And Canadians should be able to expect no third wave. 

Written by Sheena Goodyear. Interview produced by Kevin Robertson. Q&A has been edited for length and clarity.