Dr Bonnie Henry, a Canadian physician and the Provincial Health Officer for British Columbia, has been the face of British Columbia’s successful fight against Covid-19. So much so that when large crowds of people gathered at a beach this past weekend, an artist put up an installation of her face, with a stern expression, to ward off people from breaking social distance rules. The Canadian province has seen a rise in cases over the past few days, which led to some fear among people, but even that spike has been measly (102), compared with many other countries.
In April, while the rest of the world was still trying to wrap its head around the novel coronavirus, British Columbia was already flattening its curve. And much of the credit has been given to Henry. In a profile published in June, The New York Times called her one of the most effective public health officials in the world. While Henry has been credited with policies that allowed for early testing and strong messages on social distancing, she has said, unassumingly, that “part of it is, frankly, luck.”
Search for her name on social media and you will find fan accounts, something rare for government officials in any country. She was the face of the daily updates in British Columbia and perhaps a ray of hope during the dark times. A look through her Twitter fan page shows that her repeated calls for being calm and kind have even been made into bumper stickers. In British Columbia, she is not just a public health official but a bit of a cultural phenomenon.
As her book Soap and Water & Common Sense: The Definitive Guide to Viruses, Bacteria, Parasites, and Disease is relaunched in light of the pandemic, 11 years after it was first published, Henry told HuffPost India over email that it was her work for over 30 years that helped her prepare for this pandemic.
One of the biggest surprises to her, she said, was how leaders across the world downplayed the spread of the virus. Even as the lockdowns across the globe affected the underprivileged disproportionately, Henry said, “We now need to find ways to live with COVID-19 and protect those most at risk without incurring the devastating effects of ‘lockdowns’.”
In the interview, Henry also spoke about what she learned from the 2003 SARS outbreak, her time working in Uganda and how systems set up to track diseases many years ago helped track the spread of Covid-19
Excerpts from the email interview:
In the introduction to the new edition of your book, you say you never thought you would see such a situation. What about the present pandemic and countries’ response has surprised you the most?
I have been working on planning for pandemics for 30 years, and so there are many things that did not surprise me. For example, we know the potential impacts on people from the virus, as well as impacts from the measures imposed to stop the transmission of the virus: things like closing schools and businesses, closing borders and stopping travel. But most of the thinking we’ve done has been around influenza, because we know influenza has caused pandemics in the past. The biggest surprise was that a coronavirus could cause such a widespread, devastating pandemic. I really believed, at the beginning, that we had a shot at containing COVID-19 in China, but once we started seeing outbreaks around the world that hope was dashed. The biggest surprise recently has been how some leaders have so downplayed the impact of the virus, and the deadly effects that has had.
In your book Soap and Water & Common Sense, you write about one of the earliest surveillance systems set up in 1897 in New York to document tuberculosis patients. Do you think such systems failed in the case of this virus?
They didn’t fail, really, as we did pick up the signals of this infection early in China and it was very rapidly determined to be a coronavirus. And very importantly, the genomic sequence was released early on and that allowed diagnostic tests to be developed. We then were able to track the virus around the world. The surveillance systems are what enabled us to understand how this virus was moving.
Health workers, scientists and epidemiologists had repeatedly warned governments of a pandemic like this. What lessons do you think world leaders stand to learn from the present situation?
The fundamental lesson is the need to pay attention to our interactions as humans with nature, and with the animal world in particular. We had warning signs about what might happen from SARS (which spread from civet cats) and MERS (which spread from camels) and from the H1N1 influenza pandemic (which spread from pigs) in 2009. All these examples showed us that viruses can be transmitted from animals to humans, and also that some of them will be able to spread widely and cause a lot of people to become ill. Even a 1% fatality rate leads to a lot of people dying. I believe we had a sense of complacency after the pandemic of 2009 because it wasn’t as severe for most people as we had thought it might be. And we were complacent, too, because we were able to control SARS and prevent the spread of MERS; so there was this general sense that we know how to deal with pandemics and would be okay.
India is emerging out of a harsh lockdown that devastated economic activity and pushed thousands into poverty. Do you think this was the only way a country like India could have handled the situation?
It has become clear around the world that ‘extreme’ measures like physical distancing and staying at home are important when the virus is first detected in a population. But we also are acutely aware of the negative consequences of these measures, particularly on those who are marginalized to begin with. We now need to find ways to live with COVID-19 and protect those most at risk without incurring the devastating effects of ’lockdowns.” It’s important to reflect that COVID-19 is not the cause of disparities in India or in other countries; but it has certainly exposed those disparities across many domains, including the economic and health domains. Governments need now to find ways to support populations, and particularly to support those who have been most disadvantaged from the crisis. This is our opportunity to address some of these already existing disparities for the better of all.
India is now the third highest in terms of the number of coronavirus cases in the world. Was this inevitable in a country with India’s population and constraints or were there ways the government could have managed it better?
It is difficult for me to know how things could have been done differently in India, but I do know that with the huge population in India, the underlying disparities that already existed were exposed both by COVID-19 directly and by the measures to reduce its spread.
An NYT profile of you says that your time working for the WHO in Uganda taught you that communication and support works better for quarantining people than punitive measures. Can you elaborate on what lies behind this belief?
In the many outbreaks and crises that I have been involved with, I have been time and again impressed by the reactions of people. If we tell people what they need to do and why, and give them the means to do it, then most people will follow through. I strongly believe—and have seen through my own experience—that the only way we can get through a crisis like COVID-19 is through solidarity and compassion and kindness.
You called the controversy over airborne transmission of COVID-19 ‘a tempest in a teapot’. Why was this?
Mostly, I do not think there was a major difference in viewpoint between the people who wrote the letter (mostly engineers and scientists) and those of us who are monitoring and managing the outbreak (mostly physicians). The point the people who wrote the letter were making―that we should pay more attention to ventilation in situations where the virus might spread more widely, for example in closed spaces with larger numbers of people in close contact―is very valid. But we can also see that the pattern of infections would be very, very different if COVID-19 were truly ‘airborne’ as we define it in the healthcare setting.
How did your experience dealing with the 2003 SARS outbreak help you prepare for this situation?
I learned a lot during the SARS outbreak about the importance of communication directly to people, and about providing the information people need to make safe decisions. I also learned so much about the need to be open and transparent about what we know, and about how we will adapt as needed, based on what we learn. Building that trust is so important. This is when I truly came to appreciate the importance of kindness in our response; people react to anxiety and fear in different ways, and it is only by accepting this and being kind and calm that we can support each other to get through the storm.
You refused to ramp up police enforcement of social distancing in British Columbia as you thought that would traumatise people. Did that win the confidence of the community?
I believe so. I felt very strongly early on that we needed to trust people to do the right thing, and this public trust would ‘police’ itself. If we start from a punitive stance, then this can only escalate and we get into a strange situation of fining people for obscure “transgressions.” I believe public accountability and a sense of community is what will enable us to care for each other and weather the storm.
Do you hope that the field of epidemiology and medical research will get more government backing and funding after this?
Our current situation has highlighted once again the importance of a strong public health system to do those important things for the benefit of all―from surveillance to prevention, case management to contact tracing, and the essential work we do to keep people healthy and prevent illness and injury. Ironically, if we do these ongoing things right, they become easy to pare back when budgets are tight. But this pandemic has highlighted, yet again, the fundamental importance of having these strong systems in place.