Manitobans quickly got the message to go home. Now, prepare to stay there

In the space of 10 days, Manitobans went from going about their March business as usual — complaining about icy sidewalks, fretting about the Winnipeg Jets' playoff hopes — to engaging in the most dramatic collective action since the 1997 Flood of the Century, if not the Second World War.

The need to slow the transmission of COVID-19 has led people of all ages and abilities to change how they live their lives so quickly and conscientiously, it would be inconceivable if it wasn't unfolding before our eyes.

Instead of going to work, most of us are holed up in our homes, by choice or unfortunate circumstance. Instead of visiting friends and loved ones, almost all of us are buying into social-distancing practices.

The same society where people routinely freaked out if Skip The Dishes took 11 minutes too long to deliver a container of Thai coconut curry, is now focused on a single and very sombre communal aim: Prevent COVID-19 from making too many people terribly ill at the same time.

Manitobans, like all Canadians, are trying to avoid the heartbreak underway in northern Italy, where a shortage of ventilators relative to the number of severely ill respiratory patients has forced doctors to choose who lives and dies.

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Collectively, we understand the mission. But social distancing measures have come at an immense cost to many Manitobans, tens of thousands of whom are already unemployed as a result of the pandemic.

Last week alone, one in 70 Canadians applied for employment insurance. That works out to something like one in 30 Canadians of working age.

Untold numbers of small business owners are now wondering if their enterprises can survive the pandemic. Entire industries may never recover.

As well, all three levels of government are suddenly more concerned with the task of protecting the well-being of their populace over the balance of their budgets. Canada faces an economic recession so severe, it has the potential to dwarf the Depression in terms of breadth and lasting impact.

Even Manitoba's historic resilience in the face of economic hardship won't matter in the event of a lengthy recession that affects all economic sectors for a sustained period of time.

No one can foresee precisely how long this pandemic will last. At the very worst, a vaccine for the virus that causes COVID-19 is more than a year away.

Only in the movies can Dustin Hoffman synthesize a cure overnight.

What is certain is it appears social distancing measures will be in place well past the end of April. Manitobans can and should expect to be in their homes until May or June at the earliest.

"At a minimum, two to three months," said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses.

"I don't think we have any certainty about whether or not we'll be able to get this curbed in that timeframe, but I think what we do need is people to understand this is not going to be a one-week or two- or three-week turnaround, where we're back to normal.

"It is likely going to be a few months and that is kind of our target range right now."

Manitoba public health officials are sending the same signal, even if they are not being as explicit.

"It is likely to last a while, so this is really a marathon, not a sprint," Manitoba chief nursing officer Lanette Siragusa said on Sunday.

There are a number of models that suggest social distancing may be required much longer to prevent recurring spikes in COVID-19 cases over the next two years. The 1918-20 influenza epidemic, which was also mitigated through social distancing, swept around the world in a number of waves.

Widespread testing impossible, for now

To further flatten the curve, the World Health Organization has recommended widespread COVID-19 testing to identify infected patients and isolate people exposed to infection.

Unfortunately, widespread testing isn't possible in Manitoba and many other jurisdictions right now.

For starters, there are only so many technicians trained to operate the DNA-testing devices known as PCR machines at Cadham Provincial Laboratory. Chief provincial public health officer Dr. Brent Roussin said Saturday those technicians are "working day and night."

More significantly, there is a worldwide shortage of reagents, the substances required to conduct the genetic analysis that identifies COVID-19 in the lab.  Mass testing in China, South Korea and elsewhere has reduced the worldwide supply, while the international movement of reagents has been complicated by trade disruptions.

"We would love to see more testing, but I think at the same time we know that there are caveats to that," said Kindrachuk, stressing Manitoba needs to have enough supplies at hand to test the people at the greatest risk of contracting COVID-19.

Right now, that means all serious respiratory patients at intensive care units and in personal homes. It means all health-care workers and people on First Nations. It means people with COVID-19 symptoms who have returned from international travel and people who are symptomatic who've been exposed to COVID-19 patients.

The need to test other people with symptoms is lower, Roussin and Kindrachuk said, as long as those people quarantine themselves at home.

The point is to prevent people with COVID-19 from coming into contact with health-care professionals if they don't have to do so. It's a form of harm-reduction that recognizes it's more important to keep the health-care system functioning than it is to keep track of every case of the virus.

Many Manitobans are unhappy with this approach, since some studies suggest people without symptoms can transmit the virus. But as Roussin and Siragusa keep saying, people with symptoms are more likely to do so — and those people should be at home, in quarantine.

In other words, the message remains: Stay home if you are sick. Stay home if you are not sick. And expect to keep staying at home until there are leaves on the trees and the birds are singing and the days stretch into the evening.

More people are going to get sick and that is no longer avoidable. But the longer it takes for that to happen, the fewer people have to die.