The IWBI Special Report Chapter Series: “North America: A Tale of Two Countries”

In 2021, IWBI released an in-depth report that lays out research approaches and specific operational strategies as the world continues to respond to the COVID-19 pandemic and prepares for acute health threats into the future. Prevention and Preparedness, Resilience and Recovery: An IWBI Special Report integrates proven strategies from the WELL Building Standard (WELL) and actionable insights garnered from IWBI staff and nearly 600 members of the Task Force on COVID-19 and Other Respiratory Infections.

We’ve been reposting chapters from the report to help highlight specific themes and insights. The IWBI Special Report Chapter Series continues with “North America: A Tale of Two Countries,” authored by Jessica Cooper, WELL Faculty, LEED AP, NCIDQ, Chief Commercial Officer.

Excerpt republished from: Prevention and Preparedness, Resilience and Recovery: An IWBI Special Report

North America had a head start. While the first COVID-19 cases emerged in China in late December 2019, it was not until late February 2020 that the first case of community spread in the United States or Canada was identified. This head start offered a chance for the governments to prepare—to strategize how to keep the virus from spreading broadly on the continent, to ready contingency plans in case it did and to inform citizens along the way. While Canada took a more proactive and coordinated approach to their response, the United States response was complicated by competing priorities among federal, state and local decision-makers.

There are some bright spots in North America’s response, all of which have surely saved lives: decisive action by Canada’s federal government, smart guidelines delivered by local and state governments and policies set forth by private companies large and small. The different results between countries and states, and the devastation felt by so many, are illuminating. All told, the story of COVID-19 in North America offers three lessons for the world: the importance of a coordinated response across all levels of government, the power of the private sector and the dire consequences of social inequities…

Excerpt: A Tale of Two Countries
While the United States has accounted for more COVID-19 cases than any other country, Canada has weathered the pandemic comparatively well. The United States has roughly nine times the population of Canada—but it has suffered nearly 37 times the number of cases and over 24 times the number of deaths. Of course, this can be partially attributed to population density—Canada’s population is more spread out, which naturally lowers the risk. But the two countries also had wildly disparate responses from their federal governments.

While Canada is made up of different provinces and territories, the country still had a strong, centrally coordinated national response. Canadian officials appear to have learned from the 2003 SARS outbreak, when a lack of action from its federal government led to a costly intervention from the World Health Organization. In response, they revamped their public health system, improving coordination between federal, provincial, regional and local officials. During the COVID-19 pandemic, the Canadian government was prepared to offer strong unified public health guidance, federal provisioning of personal protective equipment, and a reliable testing and contact tracing system, with a national app to track cases as early as late July 2020…

Excerpt: Filling the Leadership Vacuum
Federal response is far from the only story. In the United States in particular, we have seen other institutions step up to fill the leadership vacuum—from state and local governments, to colleges and universities, to most notably, businesses.

Many state governments stepped up with effective policies to help slow the spread of the virus. Meanwhile, some local governments took decisive action as well. On June 30, 2020, the United States Conference of Mayors—representing mayors in over 1,400 cities—affirmed the importance of healthy spaces in the fight against COVID-19, passing a resolution that encouraged communities to adopt healthy building strategies…

Excerpt: Inequality is Deadly
All around the world and certainly across North America, existing racial and socioeconomic divides have worsened COVID-19 outcomes. In Canada, an analysis of case numbers during the early months of the pandemic showed that the number of people with COVID-19 in the most disadvantaged neighborhoods exceeded those in the wealthiest neighborhoods by a factor of 2.5. And while no national data evaluating Canada’s COVID-19 cases along racial lines are currently available, data from Toronto show that non-white populations are disproportionately represented in infection numbers—due, according to the Toronto Public Health Department, to “pre-existing health disparities, the stress of racism and discrimination, difficulty complying with public health recommendations due to roles as essential workers or overcrowding at home, as well as inequities in healthcare and social service accessibility.”

Similar disparities were also apparent in the United States. Asians reported experiencing more discrimination, harassment and even violence. Immigrants and their families were more vulnerable and felt disproportionate impacts. Black and brown Americans were found to be almost three times more likely to die from COVID-19 than white Americans, partially due to underlying conditions like socioeconomic status and lack of access to health care…

Conclusion
…Still, we have reason to feel hopeful. Vaccine distribution has created another opportunity for better coordination across the public and private sectors. And, given the severity of the pandemic’s impact, the United States can commit to using the lessons learned to dramatically improve readiness for the next health crisis—just as Canada did after the SARS pandemic in 2003. Hopefully, the pandemic will also demonstrate in both countries how high levels of inequality put societies at risk in moments of crisis, and why we must take serious steps toward addressing the inequities in health services, housing, education and employment—across the private sector and in public policy at every level.

Read the full section here.