'It was life and death': McNeil, Strang reflect on early handling of COVID-19 pandemic

As anxiety grew among Nova Scotians over the fear of the arrival of COVID-19 in early March 2020, Premier Stephen McNeil wanted to meet with a public health official he barely knew.

That person's name? Dr. Robert Strang, the province's chief medical officer of health.

Because Public Health operates independently of government, McNeil said there was a hesitance for the department to meet with his office.

The two men were soon joined at the hip, providing daily news conferences discussing the state of the pandemic in the province, providing consistent messaging about what people should and shouldn't be doing.

To mark the five-year anniversary of Nova Scotia's first presumptive COVID-19 cases, CBC News spoke with McNeil and Strang to get their thoughts on the province's early pandemic response, as well as if they would have done anything differently.

How Strang first learned about COVID-19

Dec. 28, 2019, might seem like a random date, but Strang remembers it well. It was the day he and others on a public health database that tracks disease activity around the world first received notification about a severe respiratory illness in Wuhan, China.

Strang said that in January 2020, he and other chief medical officers of health across the country started having phone calls about this virus.

Nova Scotia's Public Health unit had previously developed pandemic response plans for things like SARS and swine flu (H1N1). Drawing on these plans, Public Health started working with the health-care system to prepare for COVID-19. As time passed, more and more layers of government were brought into the fold.

"Can we slow it down, limit its spread while we learn more about it?" said Strang.

Strict measures

On Sunday, March 15, 2020, Nova Scotia announced its first presumptive cases. It also announced that schools, which were going to be closed for March break that week, would remain closed for an additional two weeks after that.

A day later, public gatherings were capped at 150 people. Another day later, the limit for public gatherings was lowered to 50 people.

All gyms, spas, barbershops and salons, body art establishments and nail salons were ordered on March 18 to close.

Bars were ordered to close by Thursday, March 19, while restaurants would only be permitted to offer takeout.

"Here's people who, through no fault of their own, have [spent], in many cases, decades working in this sector, building a business, [then] we called up next day and said, 'Sorry, we're closing you and you have no choice,'" said McNeil.

"Those were difficult times and decisions, but it was based on the fact that we wanted to make sure we were protecting the public health as best we could."

On Sunday, March 22, a state of emergency was declared in the province. People entering the province the following day would need to self-isolate for 14 days.

"Because of the many, many unknowns and the potential very serious nature of this virus, we had to take very strong action with closing our borders, limiting the ways people interacted with each other," said Strang.

Despite the orders, some Nova Scotians were struggling to comply with the orders. At the closing of an April 3, 2020, news conference, McNeil sounded off.

"I'm not trying to scare you, but part of me wishes you were scared," he said.

"This is serious and another weekend is upon us, I'm so tired of hearing of grocery stores, Walmart, Tim Hortons parking lots filled with cars as if we're not in the midst of a deadly pandemic — we are."

Even though he had said them earlier in the news conference, McNeil's final four words became infamous: "Stay the blazes home."

"It was the kind of blunt, plain messaging that people needed to hear that this needed to be taken seriously," said Strang. "And sometimes you need that very plain, simple, crisp message to make people sit up and take notice. And it worked."

The origin of 'Stay the blazes home'

McNeil's slogan came across as spontaneous. But it wasn't.

He said he and his team would meet every morning during the early days of COVID — McNeil called it "the first bubble in Nova Scotia" — to discuss what happened overnight and what they were seeing with the virus's epidemiology.

On April 3, 2020, the consensus was lots of gatherings were happening and some Nova Scotians weren't respecting the rules, so a strong message needed to be sent.

McNeil's chief of staff, Laurie Graham, asked him if he'd say, "Stay the blazes home."

"I colourfully said, 'No, this is exactly how I would say it,'" said McNeil. "She said, 'Well, we can't say it that way.'"

McNeil said his staff deserves the credit for the wording.

"I just mouthed the words," he said.

The words became a rallying cry and Nova Scotians bought in.

"I was proud to see, you know, they were understanding the severity of their actions and our collective actions," said McNeil. "It was life and death."

A mixture of strong rules and complicity meant that Nova Scotia became a leader in its response to COVID-19, maintaining low case numbers until the arrival of the Omicron virus in late 2021, by which time vaccines helped prevent severe illness and death.

Besides COVID-19, Nova Scotia was dealing with several other tragedies in spring 2020: the Portapique mass shooting where 22 people were killed, a Snowbird jet crash that had a Nova Scotian on board and a military helicopter crash in the Mediterranean Sea that included people with Nova Scotia ties on board.

"COVID was bad enough," said McNeil. "We had a lot of other things happening within the province at the time."

What would they do differently?

Asked if he would change anything about how the province responded to COVID-19, Strang said two things stand out.

He said officials didn't fully understand the significant long-term mental health impacts of disrupting social connections.

"Is there a way we could do things a little bit differently to minimize some of those impacts, even though we might have to use those same tools?" said Strang.

He also said they probably would have allowed more outdoor activities because the risk of spreading COVID was lessened there.

"We based our response on the best information we had at the time," he said. "And this is how responses should flow. And as new evidence and information evolves, you change your response."

McNeil said one thing he's thought about was the amount of time long-term care homes were locked down.

But he also thinks about the COVID outbreak at the Northwood long-term care home in Halifax that saw 53 residents die.

"Would I change my mind? I don't know," said McNeil.

"We knew that isolation was having an impact on our seniors. How could we best address that? Could we have done that differently? I thought about that some."

McNeil and Strang — two people who only met with each other once before the pandemic — became friends and keep in touch.

Both are proud of how Nova Scotians responded to COVID-19.

"People did really hard things that they didn't really want to do, but we had a really good response," said Strang. "And so collectively, we should be proud that we were together able to have this response, which resulted in saving large numbers of people's lives."

Since the beginning of the pandemic, roughly 1,250 Nova Scotians have died from COVID-19.

"COVID's here," said Strang. "It's staying."

He said we need to remain respectful of what he calls the "normal kind of ecosystem of respiratory viruses," such as influenza and respiratory syncytial virus (RSV). COVID-19 is now part of that group.

While messages of handwashing, staying home if you're sick, wearing masks and getting vaccinated were dominant during COVID's peak, Strang hopes we still keep them in mind.

"We have to take appropriate, reasonable precautions to keep each other safe while living our lives as normal as possible, especially in the winter months when we have these viruses around," he said.

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