Saskatchewan's 4th wave response: wait and delegate

In just a few short months, Saskatchewan has gone from promising to light firecrackers to playing catchup in all the categories that matter when it comes to the COVID-19 pandemic as a fourth wave threatens to engulf the province.

Earlier this year, Saskatchewan led the country in vaccine uptake, leading Premier Scott Moe to criticize federal vaccine procurement and the federal response in general.

But now, months of progress have evaporated and the tables have turned. Canada is now a world leader in vaccinating its people, while Saskatchewan has among the lowest vaccination rates in the country, and on Tuesday reported its highest seven-day average at any point in the pandemic.

Health officials and critics say the government's response to the fourth wave hasn't been strong enough, and that the situation the province finds itself in comes down to a lack of action on four fronts: vaccination rates, masking policies, testing and tracing efforts and the lack of a proof of vaccination system. Instead, the province's approach seems to be one of waiting to see what action is needed, then delegating that responsibility.

Vaccination rates 

The premier had criticized the federal government's vaccine acquisition and distribution before vaccines were readily available in Canada in November 2020, saying the country would be at the "back of the line." 

At the time, Moe said vaccinations were the province's "path out of the pandemic." 

In February, when Saskatchewan was ahead of the national average in fully vaccinated people, Moe said he and other premiers would help light a firecracker under the CEO of pharmaceutical company Pfizer to get more vaccines shipped to Canada. 

He also criticized Canada's standing in vaccinations and the federal procurement program, saying Canada was, at the time, 34th in the world. 

More than six months later, the positions have flipped. On Tuesday, Canada had vaccinated 68 per cent of its population, ahead of the U.S., the U.K., France and Germany.  

Meanwhile, vaccination rates in Saskatchewan now trail all provinces except Alberta, with 71 per cent of people 12 and over fully vaccinated, along with 60 per cent of the overall population. The Canadian averages are 77 per cent and 68 per cent respectively. 

According to the province's own numbers, about 87 per cent of new cases reported Tuesday were in people who hadn't been fully vaccinated, while 79 per cent of hospitalizations in August were people who hadn't been fully vaccinated.

Masking policies 

On July 11, Saskatchewan removed all public health measures, including its masking policy. 

Two weeks ago, British Columbia and Manitoba reinstituted mask policies for indoor spaces. Alberta followed suit Friday. 

Though Saskatchewan hasn't indicated it will bring back a mask policy, in a recent interview with CBC, Chief Medical Health Officer Dr. Saqib Shahab strongly recommended people wear masks in crowded indoor spaces. 

Last week, Moe called returning to measures like masks "grossly unfair" to those who are fully vaccinated.

Regina and Saskatoon have implemented mask mandates for city facilities and buses due to rising COVID-19 cases. They said they were relying on advice from local medical health officers with the Saskatchewan Health Authority (SHA). 

Moe has said those officers could make decisions on local matters like school division health policies, but that his government will take its cues from Shahab. 

The local medical health officers also wrote a letter on Aug. 26 calling for measures they said would slow the spread of COVID-19, including a return to making masks mandatory indoors. 

But the province has largely ignored those recommendations, instead promising only to get a portion of health-care workers fully vaccinated. No such policy has been presented yet, according to the union representing thousands of Saskatchewan Health Authority employees. 

On Aug. 30, Moe and Shahab formally addressed the public and answered questions about the pandemic, the first time they'd done so since July 7.

Testing and tracing  

Both Moe and Shahab have said the public must get used to living with COVID. 

The province has a Living with Covid page on its website that says COVID-19 testing will still be available, but locations and hours may vary based on transmission rates and demand. It also says contact tracing will continue.

But on July 19, the SHA scaled back testing hours and staffing. Spiking cases in Saskatoon mean long lines at the testing centre, which shut down three hours early last week after reaching capacity. 

The SHA also announced Friday that its new "modified approach" to contact tracing will place the responsibility of doing so on the COVID-positive person. The SHA will inform the person about how to trace, then leave it to them. 

"Leaving this up to the public to do is … absolutely irresponsible, and it's putting all of us at risk," said Tracy Zambory, the president of the Saskatchewan Union of Nurses. 

She called it a "dereliction of duty" by both the SHA and the government, and said without contact tracing, health-care workers have to "brace for a storm that we can't see coming."

Proof of vaccination  

Both Moe and Health Minister Paul Merriman have balked at the idea of a provincially mandated proof of vaccination system since the possibility was raised in the spring. 

"I think you're infringing on people's personal rights if you're mandating things," Merriman said recently. 

B.C., Manitoba, Quebec, Ontario, and Nova Scotia have all recently introduced policies requiring proof of vaccination or a negative test to take part in activities and events at both public and private businesses. 

Local medical health officers have called on Saskatchewan to do the same, but the government has resisted. 

Last week, the province said in a statement that municipalities and organizations can create their own policies, but only where they have jurisdiction. Regina and Saskatoon would not be allowed to implement a policy on private businesses, the government said. 

Moe said he supported the Saskatchewan Roughriders and Saskatchewan post-secondary institutions in their decisions to require proof of vaccination and said the government would provide the record through eHealth, which will eventually be offered as a QR code. 

Demand for vaccine documentation has placed pressure on eHealth, resulting in an outage last week. 

Next steps

As caseloads rise and vaccination numbers increase, Saskatchewan health officials, doctors and residents are waiting to see if the government will step in.

"If we were to adopt some of those measures like the mandatory masking, and perhaps introducing more vaccine certificates or proof of immunization and certain types of venues, we can still blunt this wave," said Dr. Cory Neudorf, the interim senior medical health officer for the SHA. 

"The main job of public health is to try to be future oriented and in future forecasting, we're in the business of preventing disease."

Dr. Eben Strydom, the president of the Saskatchewan Medical Association, called for a provincewide vaccine passport plan.

"That is essentially what would help us get to the goal of having more people vaccinated way quicker. That would save lives. That would save a lot of pressure on the health system as well," said Strydom, a family physician in Melfort, Sask.

Dr. Alex Wong, an infectious disease physician, took to social media Tuesday calling for immediate measures to deal with rising cases and hospitalizations, specifically in Saskatoon, where Mayor Charlie Clark said surging cases are putting "a huge amount of stress" on the city's ICUs and health system.

"Our emergency rooms are on bypass. It is a very stressful time for the community," he said, and suggested Saskatchewan needs a "co-ordinated provincial approach" to avoid any damaging lockdowns.

In response to Clark's concerns, the government said in a statement to CBC it was monitoring the situation closely and will "respond accordingly in co-ordination with Dr. Shahab and our public health officials."