Bioethics Forum Essay
U.S. and Canada: Being Good Neighbors in the Pandemic
The United States delayed public health response to the Covid-19 pandemic has been wildly uneven, not to say bordering on chaotic. It has been characterized by mixed messaging and at times misinformation, racism, and scapegoating from sources including federal, state, and city governments, as well as commentators on traditional and social media.
Thankfully, in Canada, federal, provincial, and territorial public health officers have been speaking clearly and in one voice. They are widely respected and, for the most part, their advice has been heeded. This appears to have had a positive impact on the number of infected persons and the number of deaths. Our current death toll is 734. Sadly, close to half of these deaths are linked to long-term care facilities. While these are early days for us, the total number of deaths compares favorably with the situation in the U.S.
In the U.S. today, April 14, the death toll is 21,972, nearly 30 times the number of deaths in Canada. If we look at this number on a per capita basis, proportionately the U.S. has lost significantly more lives than Canada. The U.S. has the third largest population in the world, currently estimated at 330 million. Canada is a country of 37.75 million.
The ever-increasing number of deaths in the U.S. is of great concern to Canadians. Many Canadians have close personal ties with Americans–some are family, some are friends. Many of us work across the border and sojourn there in the winter months. We also enjoy the culture of New York City, Chicago, and New Orleans, and the great outdoors in California, Oregon, and New Hampshire. In these and many other ways the lives of Canadians are intertwined with the lives of Americans.
Canadians worry about Americans who are vulnerable and who do not have access to health care. We worry about those who are, or will soon be, unemployed or under-employed, as well as those who have recently graduated and have lost their job prospects. We worry about those who will experience myriad disruptions in their lives if they are unable to pay their bills for housing or food. We worry about families who are unable to be together at this difficult time.
At the same time, many of us feel vulnerable. Our sense of vulnerability in relation to the U.S. is not new. Fifty-one years ago our former Prime Minister, Pierre Elliott Trudeau (the father of our current Prime Minister Justin Trudeau), uttered these now famous words: “Living next to you is in some ways like sleeping with an elephant. No matter how friendly and even-tempered is the beast, if I can call it that, one is affected by every twitch and grunt.”
Our perceived vulnerability is particularly acute at this time for two reasons–our unavoidable proximity and continued cross-border travel by some Canadians. The Canada-U.S. border is the longest non-military border between two countries (5,525 miles). Ninety percent of our population lives within 100 miles of this border, and viruses care nothing for political borders.
While this border has been closed to all nonessential travel since March 21, there is still considerable traffic between our countries. For example, everyday, about 1,600 nurses and other health care workers commute from Windsor, Ontario, to Detroit, Michigan. There are more deaths from Covid-19 in Detroit and neighboring counties than in all of Canada. This fact has resulted in calls for increased border restrictions and, more specifically, for Canadian health care workers to stay home.
In these turbulent times of fear and anxiety, Canadians and Americans need to find ways to build and maintain trust within and across our borders. We could do so by focusing on our overlapping self-interests and mutual interests in health and safety.
We need to work together to develop a coordinated scientific, clinical, social, political, and economic response to the pandemic. A common approach to containment and mitigation, as well as a common approach to easing ourselves out of the current emergency lockdown, will benefit us all. It will also help us to pay close attention to our respective vulnerable and marginalized populations–those who live in long-term care facilities or in prisons, those who have chronic health conditions, as well as those who are racialized or experiencing mental health challenges.
Life as we once knew it has forever changed. There is no going back, no return to normalcy. As we build our future, we have every good reason to find ways to do this hand-in-hand. Our best chance of securing a brighter future for us all depends on developing a common, evidence-informed, predictable, and consistent plan for both our nations. As good neighbors, we owe it to ourselves and to each other.
[After this essay was published, autopsy news revealed that the first coronavirus death in the U.S. was much earlier than previously known. This essay has been corrected to remove a reference to the date of the first known death in the U.S.]
Françoise Baylis is University Research Professor at Dalhousie University in Halifax, Canada. Twitter: @FrancoiseBaylis.
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Thank you, Françoise, for this eloquent and urgent message to remember our relationships and to find common purpose. I would add that the U.S./Canada border is not only undefended but, in some eyes, imaginary, especially from diverse Indigenous perspectives. Perhaps we can also note this, and, our mutual obligations to potentially and historically vulnerable persons on both sides of that dotted line.