COVID-19 | Lessons from a pandemic, one year later

A year ago, I shared in these pages my thoughts on the COVID-19 pandemic.⁠1



Nazila Bettache

Nazila Bettache
Doctor, assistant professor at the Faculty of Medicine of the University of Montreal, and member of the Soignons la justice sociale collective *

After 22 months and while hospitalizations are skyrocketing in Quebec, it is with terror and sadness that I see that these “lessons from the pandemic” have come to nothing.

Starting with the inaction of the government of Quebec in the face of warnings from the models of the National Institute of Public Health of Quebec (INSPQ) in November, which announced a major increase in hospitalizations in January and February, and this, even before the arrival of the Omicron variant.

This inertia continued in the face of European data announcing the strong contagiousness of the new variant. Faced with this worrying information, the Legault government has chosen to inform us of gatherings of 20 people vaccinated during the holiday season.

Then, the establishment of a curfew which brings us back to the winter of 2021. This repressive measure, in addition to being illogical – since it does not in any way stem all the transmission which takes place during the day in the schools, daycares, workplaces and communities – will disproportionately affect the most marginalized communities in society.

It will have the consequence – once again – of exacerbating the harmful and unevenly distributed impacts of the pandemic, in particular on young people, people living in precarious housing or without immigration status, those who have recourse to the centers of supervised injection or experiencing violence at home, sex workers, etc.

As several have already repeated, relying on police repression to manage a pandemic constitutes a failure of public health policies.

Have they already forgotten the deaths of Raphaël André and Elisapee Pootoogook? In the midst of “pandemic fatigue”, the announcement of the curfew also risks eroding the population’s confidence in public health authorities, at a critical time when collective action for the common good is essential.

Inconsistent speeches

Instead of focusing its message on quality information allowing the population to anticipate and make informed decisions, the government of Quebec has chosen to stun us with incoherent discourse alternating between false hopes and the stigmatization of scapegoats who serve to camouflage its failures. However, neither hope nor repression constitute public health strategies.

I want to be clear. I think it is crucial and urgent to reduce the transmission of the SARS-CoV-2 virus and to apply the health measures that we know to be effective. But it is still necessary to give the population the means to apply these measures.

This would imply access to quality masks – including N95 masks -, well-ventilated living, working and learning environments (this is a respiratory virus!). The population must have access to screening tests and must be financially or logistically supported during a test or quarantine.

We must put in place measures targeting schools, warehouses, factories and other workplaces that are experiencing outbreaks, accounting for more than half of the cases currently in Quebec. We must also question the “hospitalocentrism” of our system and rethink the social model of institutionalization, including CHSLDs, shelters and prisons, which have been hit hard by the virus.

Further upstream, concerted action is needed on the structural determinants of health, which embed the heterogeneous impact of this pandemic.

Repeating mistakes

We are facing the same storm, but we are not all in the same boat. Access to affordable quality housing, safe and dignified working conditions, and financial support programs in the event of illness or job loss are all essential factors in this pandemic.

Each wave of confinement should – should have – allowed us to put all these measures in place and strengthen our healthcare and public health infrastructure. Instead, it seems that the Coalition Avenir Quebec government is repeating the same mistakes every time, while hoping for different outcomes.

This brings us back to a lack of a global vision that is as frightening as it is worrying. The word pandemic implies a phenomenon that operates on a global scale, therefore requiring equally comprehensive solutions.

A year ago, we were told the arrival of vaccines as the panacea that would get us out of the health crisis. However, this important element of the strategy to fight the pandemic has only exacerbated pre-existing inequalities in the distribution of wealth on a global scale.

Indeed, how to orchestrate a fair and equitable distribution of vaccines against COVID-19 in the countries of the global South within political and economic structures that perpetuate the colonial heritage, undermine the development of local infrastructures and normalize the millions of people? who die there each year from tuberculosis, malaria or viral gastroenteritis?

There is no local solution to a global phenomenon. The slogan “no one is protected if we are not all protected” from the World Health Organization reminds us that we must think of deep, collective and united solutions. This is the only way to get out of this pandemic, together, and prevent the next one.

Thanks to Arnold Aberman, Baijayanta Mukhopadhyay and Samir Shaheen-Hussain for their contributions to the text.


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