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Brent H. Cameron: The rural-urban split matters more than you think

Commentary

One constant refrain during the debates among Canadian conservatives is that the movement is ill-served by focusing on what we call the rural-urban split, the predilection of rural seats skewing Tory while big city ridings are dominated by Liberals and New Democrats.

Some believe that this is a distraction that prevents the movement from modernizing into a more relevant political force. The logic dictates that by shedding that mindset, conservative parties can be more competitive.

They are wrong, but not for the reasons they think.

Back beyond the arrival of Jacques Cartier and the founding of New France, Canada and its constituent parts were rural societies. Most Canadians lived in sparsely populated areas, with the largest population centres being roughly equivalent to a moderately sized city by today’s standards.

According to Statistics Canada, in 1851, nearly nine in 10 Canadians were rural dwellers, and the economy was driven by primary sector industries, such as agriculture, forestry and mining. Between 1921 and 1931 the percentage of the population who lived in rural areas dropped below 50 percent. During that period, Conservatives held government in pre-Confederation Canada and federally thereafter for a total of 44 out of 66 years.

From the 1930s on, the rural population has steadily declined to its present level of around 15 percent. During that time, the Liberals have held power federally for 60 out of 91 years.

And it is not just a Canadian phenomenon. Every major western industrialized nation sees this pattern hold. Americans talk about “red states versus blue states,” while people in the U.K. reflect upon how different politics in southern England is once you get outside the gravitational pull of London.

The change in where Canadians live has meant a change in how we live.

And it’s not just conservative movements that are challenged in navigating this urban-rural split. One need only reflect on the character of New Democratic politics in big city Canada in 2021 as opposed to the version that sprang up among Prairie farmers in the 1920s and 1930s and was defined by the co-operative movement.

The change in where Canadians live has meant a change in how we live.

Rural life is defined by lower concentrations of population and more personal space. Government at the local level is modest in its service delivery and its regulatory demands. There are few differentiations based on social class, with rich and poor often living side by side. Social groupings skew more toward mutual aid and community priorities rather than advocacy and lobbying.

The exchange for more personal volition is fewer official supports. You act as your own public utility, maintaining your own well and septic, and hauling away your own garbage and recyclables. It is a social and cultural environment that naturally skews to less demand for government intervention by expectation setting.

In contrast, higher density living in an urban core means a higher emphasis on policies related to social cohesion and arbitrating relations between people, such as settling disputes over property lines, noise or behaviours that might have an impact beyond a condominium wall. Open spaces like parks are communal, requiring rules for use and conduct.

Government also provides buses and subways to get you from one place to another, the pipes that bring you safe, clean water to drink and pipes to take away the waste you generate. They run the trucks that pick up your trash and recyclables and send out the enforcement staff who referee disputes with your neighbour.

Urban areas, by function, require a higher degree of coordination of activity. A man yelling in the middle of a 50-acre parcel of land is not likely to be noticed, but the same act performed in the backyard of a suburban home, or on the balcony of an apartment unit will not escape attention for very long. That coordinative authority naturally falls to government as the honest broker that represents all.

More than 80 percent of Canadians inhabit an urban living space and have done so for at least a couple of generations. That comes with an urban mindset, one that does not see either big government or interventions as inherently bad but as indispensable to your daily life, playing a major role in arbitrating social interactions.

The challenge for the modern Conservative movement lies in this fact. So, what is the answer?

When it comes to how much government there is in our lives, there is still a quantitative argument to be made. The expansiveness of its activity in our daily routines is a legitimate issue, particularly considering the federal government’s recently proposed foray into regulating activity on the Internet.

What does not happen nearly enough is the qualitative argument: whether government interventions are justified by the amount of personal freedom demanded in exchange. But if freedom were a form of currency, should we not ask whether we are getting value for what we pay? Are we being overcharged relative to the benefit we receive?

In the City of Brampton, for example, relatives have told me that bylaws extend to the number of branded company cars that can be parked overnight in your own driveway (less than two from different companies), and that in particular neighbourhoods the colour of the metal kickplate you choose for your front door can be a major point of contention. These curbs on liberty may enhance property values or assuage finicky neighbours, but do they contribute to a better society?

Economists are well familiar with the Laffer Curve when determining optimum levels of taxation for revenue generation. We never ask whether there is an equivalent curve that measures the optimum amount of personal freedom we must pay to have a society that delivers the greatest good for the greatest number. And maybe that is the starting point.

Conservatives are at their best when they make the value proposition in terms of dollars spent. So why not apply the same cost-benefit principles to what personal freedoms people are asked to give up for a greater good, and building a coherent ideological argument around it?

It may not work. Then again, the movement might just achieve the breakthrough it seeks.

Harry Rakowski: Long-haul COVID-19 is another pressing reason to get vaccinated

Commentary

Our initial fear of COVID-19 infection was of becoming seriously ill, ending up in hospital and possibly even dying. Through each of the three waves of infection, the pressure of infected patients filling hospitals and scarce ICU beds led to a marked reduction in non-emergency care even for serious need.

As infection rates drop dramatically more than 70 percent of Canadians over age 12 receiving at least one jab and nearly 20 percent being fully vaccinated to date what do we still have to worry about?

The Delta variant, recognized in India, appears to be more resistant to a single vaccination dose. That means it is essential that high risk people — those over 60 or with obesity, diabetes and immune-compromised conditions — receive priority for second shots. They also need to be encouraged to do so through ease of bookings and increased efforts to overcome any residual vaccine hesitancy.

Getting a second shot for as many people as possible remains essential to keeping case rates and hospitalizations low. In order to achieve relative herd immunity we hope that over 80 percent of people eligible for vaccination will be fully covered by the end of summer. Canada has a very large vaccine supply coming in the next two months making timely second shots readily available.

The burden of getting COVID-19 goes beyond the initial effects of infection. We now know that there can be very significant long term effects that can persist for months or longer. The syndrome is know as “long COVID“ or “long-haul COVID.”

COVID-19 infection can involve multiple organ systems including the lungs, heart, brain and kidneys. This is a result both of direct infection and a potential over-reaction of the body’s natural immune response. While most people who are infected resolve symptoms within 2 weeks, there is a growing body of scientific literature that characterizes the nature and duration of persisting symptoms.

The diagram below from emergency-live.com highlights the organ systems that COVID-19 infection targets with potential long-lasting impact. Possible mechanisms include prolonged inflammatory response, nerve damage, retained viral load and blood clotting problems. There is also a major psychological effect to being severely ill with potential long term mental health consequences.

The lungs are a prime target of infection. While COVID pneumonia generally clears early, a small number of patients may have lingering scarring that may be permanent and can reduce lung function with persisting shortness of breath. Others may have blood clots leading to strokes, kidney damage or small blood vessel blockage and lingering disability as a result.

A large United States Department of Veterans Affairs study showed a 60 percent increase in all cause mortality within six months of infection especially if hospitalization was necessary.

In a Swedish study of infected health care professionals, 80 percent of hospitalized patients experienced moderate to severe symptoms for many months after initial infection and 10 percent of all those infected, but not hospitalized, experienced one or more moderate to severe symptoms affecting quality of life for more than six months.

A common specific symptom of infection is loss of smell and taste. While not life-threatening, it is very challenging to many and may greatly affect quality of life. The virus does not appear to directly damage the nerve cells that allow us to smell and taste but rather their supporting cells. While these sensory losses may persist for two months after infection in about 25 percent of affected people and in 15 percent beyond eight months, function will ultimately recover in most people.

The virus also affects brain function, perhaps by causing an inflammatory reaction. This can result in persisting brain fog with difficulty concentrating and memory impairment, as well as anxiety and depression.

Chronic fatigue is a known major complication of some viral infections especially mononucleosis and is a significant long-COVID symptom as well. Many patients describe a persisting inability to work or function at a high level.

Vaccine hesitancy has been increased by the belief that healthy people who get infected will only feel like they got the flu. However, it is important to remember that even those with mild symptoms may develop long-haul COVID symptoms, which can be debilitating.

It is estimated that about 20 million people worldwide will develop long-haul COVID symptoms. We don’t yet know who is most at risk other than by the severity of infection. Unfortunately there is no effective treatment to date.

Physicians and patients need to respect that unusual and persisting symptoms after infection are real even when conventional testing fails to reveal blood or imaging abnormalities.

If you are young and healthy and, as a result, vaccine hesitant, preventing long-haul COVID is another good reason to get fully vaccinated as soon as possible.