Just months after being named Canada’s new health minister, Patty Hajdu was confronted with the biggest health crisis in modern Canadian history. With no end in sight, the pandemic has derailed much of the Liberal government’s agenda. Hajdu, who prior to her current portfolio was the minister for women and gender equality, and before that ran a large homeless shelter in her riding in Thunder Bay, Ont., spoke with Paul Wells about the urgency during the first months of the outbreak, her own sense of dread as the virus spread across Canada, and the impact the crisis is now having on everything from federalism to Canada’s relationship with China. This conversation was part of the Maclean’s Live series.
Q: I don’t know if you have any thoughts to sum up this journey you’ve been on with all of us since this crisis began—where are we in the arch of this management of this crisis?
A: To be the health minister at the time of a global pandemic, the likes of which we haven’t seen in size or intensity in 100 years, is really quite sobering. In terms of the question around how we’re doing as a country, I would say we’re cautiously optimistic that we’re flattening the curve. We’ve managed to avoid that kind of crushing surge on hospitals that we’ve seen in other countries, including our closest neighbours and friends to the south of us. But that doesn’t mean that we’re out of the woods yet.
We have some big decisions ahead of us as a country, and as well in terms of how we increasingly restart our economy and rejoin the international world.
Q: What can you tell people who are wondering, “Well, wait a minute, wasn’t this supposed to be over by now?”
A: Well—first, I’d say I completely share their desire to go back to what we called normal. I think it’s a strange phenomenon to be the health minister, because I’m also just a regular human being and I miss all the aspects of regular human life. I would love to go out for dinner with my friends or go grab a glass of wine. So, I feel that anxiety and that frustration.
I can say also that, as we learn more and more about the virus, I think we will start to see more and more “normality.” But right now, given that we have limited options in terms of treatment and limited options in terms of protection in terms of a vaccine, we do have to be more cautious, and we’re learning together how to do that—and it is painful and it is slow.
Q: How worried are you about a second wave?
A: I think everybody is worried about the coincidence of additional infections, along with the increase in flu activities that we see every single year. We know that influenza picks up its activity—actually, somewhere around now—and starts to gain steam into the fall and winter. And what we really want to do is make sure that we’re not having a surge of flu at the same time as we can see surges of coronavirus.
And so I am worried, but I also am confident that the provinces and territories are doing what they need to protect their [health-care] systems, and that we at the federal government are supporting them with resources and tools.
Q: When did you begin to realize that this was going to be really serious, and that your agenda for this entire term in office was going to be on hold for a while?
A: I think I had a growing sense of dread over the several months that we saw this pick up steam in China, first of all, and then as it started to transmit around the world. I had a growing sense of anxiety that we too were not going to escape being hit with the coronavirus.
The weekend that we made the decision to close the border was a very profound one. You could feel the ground shift. When you take a big decision like that that has international consequences, that is not so easy to unroll. I think you know that you’re in a new world and that, rapidly, countries were making those decisions as well, and that it was going to be very hard to imagine going back to normal.
Q: Already on Feb. 25, you had suggested that people might want to go out and get vital necessities, which was a statement that, at the time, seemed quite jarring. Was that an expression of this dread that you’re talking about?
A: What I asked Canadians to do was to prepare for an extended period of illness of themselves or their loved ones, because we knew that people that were getting coronavirus—the Canadian cases that we had—were demonstrating that this wasn’t something you got over in three days, and that also you had to be quarantined or isolated while you were sick. So I was asking Canadians to be ready. And yes, I wanted to indicate to Canadians it was serious.
Q: Ontario and Quebec between them account for 95 per cent of the deaths due to COVID-19 in the country to date. Alberta and B.C. account for 80 per cent of what’s left. In most of the provinces and all of the territories, there essentially is no pressing crisis. What kind of challenges does that present?
A: It’s a really big challenge, because of course some of the measures that we’ve asked Canadians to take—particularly around the social distancing and physical distancing—don’t make sense sometimes for a community like Manitouwadge, in my riding, which is far off the beaten path. Nonetheless, we also know that, again, there is a risk to even small communities and, in a way, especially small communities. As we’ve seen when we have an outbreak in a plant that isn’t actually in a large centre, it can create quite a crisis.
Q: If I’m in New Brunswick, why should I not be going out to the park, why should I not be reopening my hair salon?
A: At the national level there never was “a lockdown.” We were really giving advice nationally, but at the provincial and territorial level—that’s really where those particular regulations came into place about whether or not shops could be open. In B.C., for example, they didn’t have a complete shutdown; there were many sorts of stores that were allowed to stay open.
Q: You had been minister for a month and a half before all of this began. Were you briefed in those crazy first days on pandemic preparedness plans?
A: I actually knew that Canada had a pandemic plan. You get all these binders as the new minister, and you read about every little agency that you have the responsibility for, and what they are working on and their programs, et cetera. So, I had actually just finished that work, and I was first briefed by Dr. Tam in early January about the suspicious cases that were being reported out of China. But again, it was very early days, so it was not as alarming just because I do have that background in public health—so I knew that there was an alert system, and I knew that this was sort of normal behaviour for public health officials to be on guard for this.
Q: Once there were cases in Canada, the first deaths in Canada, the cabinet committee started. What was your planning horizon? Were you looking forward to getting over the hump at the end of May?
A: I was very grateful that the Prime Minister pulled together the special committee. I likened [COVID-19] to a tsunami, [in] a way—you know it’s coming, and those of us who are the early alert system of health saw this thing coming and, you know, we were preparing from a health perspective. But it was very clear, as those waves were washing on the shores of Canada, that it was going to have a massive impact on other things besides health.
Q: You have sounded skeptical about the usefulness of closing borders, from before the Canada–U.S. border was closed. How come?
A: First of all, there are international health regulations [that] say, during a global outbreak, that we should not shut down our borders and we should not in any way inhibit trade or travel because, in fact, the most effective way [to track an illness] is to do screening at the borders and to try to catch those cases. I think what happened for me, though, was—as we saw the pandemic evolve—what became clear is that the capacity of other countries to understand what their own disease outbreak looked like was not there.
Q: Would you put China on the list of countries that haven’t been entirely transparent?
A: I think there is going to be a post-pandemic review of all countries’ actions, and I am certain there will be lots of questions about China’s actions in those early days.
Q: There are more generally questions about this government’s stance on China. Does it see China as an investment partner, an ally, or does it see it as an increasingly belligerent force on the world stage?
A: I think our government has always been clear that the way to manage, even with difficult countries, is one of collaboration if possible, but—for sure—communication. In terms of a global health response, we are not going to be able to beat down any global illness unless we actually worked together with countries, and there is an opportunity to welcome countries to the table to participate in those conversations with a healthy degree of questioning.
Q: For all the pandemic planning, nobody had really anticipated a global shutdown of the day-to-day economy.
A: Certainly at Health we had prepared what we called scenario binders for all of the ministers about, should we see this kind of disruption, what it might mean.
Q: I guess what I’m getting at is, I’m not aware of a binder that says, “Here’s how you shut down an economy.”
A: So true, and you know what doesn’t exist? “Here is how you start one up.” So that is what the world is grappling with now. I mean, take the issue of international travel. You know there is no best practice for how you reopen the borders once the entire world has, to some degree or another, stopped international travel. And so, we are working with international partners, and with the IATA [International Air Transport Association] and all kinds of different organizations, to look at what will inevitably become a new world order about how we screen from a health perspective in a more comprehensive way.
Q: Federalism has kind of become a bit of a rusty machine. Did you have to relearn very quickly how to work with the provinces, and what was that like?
A: Every minister of health across the country has my cell phone number and they call me bilaterally whenever they need to talk to me about whatever the issue is, and likewise I can call them: and we do. We also have regular meetings—in the crush of it, twice a week; now once a week—to talk about what kinds of supports they need from me, what’s going well, what’s not going well. In many of those ways, the pandemic has broken down some of those barriers that exist.
Q: I think a federation should work like that most of the time.
A: Exactly, it would be wonderful. You may not always agree [with] or even like the person you are working with, but there has to be a foundation of respect and openness. I truly believe that this pandemic has taught us that this isn’t me talking to the Government of Ontario—this is me and minister Christine Elliott working together on solutions for Ontario in a very challenging time.
Q: Let’s talk about those long-term care homes. Why did it need Canadian Forces soldiers writing back to their superiors in Ontario and Quebec for government attention to focus on what seems to have been a crisis that was already underway before COVID happened?
A: Yeah, it’s a pretty disturbing report. There is no way you can read it and not feel horror. I felt incredible sadness. I had a loved one die in long-term care; it was in no way as appalling as what was reported in that document. But nonetheless, the care was not what I would have considered satisfactory.
We have heard many stories of families that augment care to make sure that their loved ones are fed. This is not surprising, I think, to Canadians. It’s shocking in its extremeness but it’s not surprising, and I think it’s a wake-up call for all governments to say we have to do better. I think there’s a much larger systemic fix that needs to happen.
Q: Is the federal government prepared to put money in?
A: I think the Prime Minister was very open to saying that we will be there to help support provinces and territories, but we obviously do respect that this is a jurisdictional authority of the provinces and territories. Nonetheless, I don’t think Canadians want us to argue about who is supposed to fix that.
Q: Is there room here for a national plan, intense federal-provincial collaboration leading to national standards?
A: Well, that’s the challenge, when the federal government steps into a jurisdiction for which it does not have authority to mandate specific approaches; when we know that some provinces and territories are doing very well in the area of long-term care, and some provinces and territories have recently changed how they deal with long-term care, specifically as they saw COVID affect the care of the elders in their communities. Things always work better when you work with provinces and territories, instead of trying to dictate to them how to do it.
Q: This crisis isn’t the only thing happening in health in this country: there’s an opioid overdose epidemic that’s in its fifth year; and there is growing concern over mental health, that people are facing increasing strain from the kind of lifestyle that we are all having to live right now. Are you able to devote some of your time to these concerns?
A: Absolutely. In terms of mental health, we saw early on that there was going to be a need for additional mental health resources. We launched something called Wellness Together, which is an online portal where people can go online and get self-help tools, but also connect to professionals either by phone or text or virtual care. We have been investing in things like supporting the crisis hotlines, the suicide lines, the Kids Help phone lines, ensuring that the domestic violence hotlines can maintain their services.
One of the things that I am most proud about in terms of our approach to substance use is the restoration of harm reduction to the drug strategy. That is making safe injection sites easier to start in communities that want to have them, ensuring that people have a safe supply if a community wants to be using that particular tool. There is way more to do on substance use, and part of it is having a broader conversation about substance use and just how endemic it is in all of our lives.
Q: I still hear from a lot of people who say the best answer to all of these problems would be to just let people get back to their lives. How long is this path from our lives likely to last?
A: That’s a hard question, and it’s the one I have been asked over and over and over. Everybody wants to know when things will go back to normal. I don’t know if things will go back to normal until we have an effective treatment or a vaccine. I think the challenge with coronavirus is that, for many people, it’s not going to kill you—but for those few people that it will, it’s extremely, extremely dangerous.
And so to protect those people in our lives who are elderly, who do have vulnerable health conditions that make them more vulnerable, we are going to have to adapt the way that we live—and I think, you know, even people that get the illness who are well sometimes have a very severe bout of illness. So, I think it’s going to be a while; that we are going to have to learn how to live in a way that really focuses on protecting our health.
Now the good news is there are some things that are pretty simple to do. We are all remembering to wash our hands and use hand sanitizer. We are going to have to stay home when we are sick—that’s harder, that’s a cultural change. We have a culture that’s very driven, and people go to work when they are sick for a whole bunch of reasons—sometimes money, but sometimes because we have sent signals as a society that you battle through that sore throat or that headache, or even that sort of bad head cold, and that has to change.
And then, finally, we are going to have to stay physically distanced for a while outside of our household bubbles. And how long? Well, we are investing a ton of money in our research community and supporting that research that will help us better treat, prevent this illness, and that really is the long-term answer.