Did Ontario get it right? Did Florida fumble?

Comparison of Ontario and Florida COVID responses

Florida is often held out as the poster boy for appropriate COVID responses - no lockdowns; no mask mandates; no business closures. Florida earned that status by having few differences between its COVID outcomes than America generally, with only minor differences in infection rates and deaths. American states have generally had worse outcomes than Canadian provinces during the pandemic. We should be pleased we live in Canada and in Ontario in particular, when compared to the U.S. experience, if we are looking solely through a public health lens.

Let’s review some of the data.

There is a stark difference in approaches and outcomes between Ontario and Florida in dealing with the COVID 19 pandemic. Florida has a population of almost 22 million while Ontario’s population is about 14 million.

Florida publishes weekly COVID updates with relatively complete demographic data in a lucid format, as does Ontario. Since the pandemic began, Florida has had 63,763 deaths “with COVID” while Ontario has had 11,130. Expressed as a rate per 100,000 people, Florida has had over 24,000 deaths while Ontario has experienced 6,680. The numbers are striking - Floridians were about four times as likely to die with COVID than people living in Ontario with a mortality rate of 290 per 100,000 people in Florida and only 74 per 100,000 in Ontario. I like the weather and beaches in Florida and often gripe about our cold winters here in Ontario, but from a public health point of view, Ontario seems to have done better in terms of preventing COVID deaths.

Vaccines played a role but not a major one. 78% of Ontarians are “fully vaccinated” while 73% of Florida residents have received at least two doses of a vaccine. For people over aged 60, the most vulnerable to COVID, 90% this age group in Florida have been vaccinated and 95% of the same cohort in Ontario. Under Doug Ford as Premier (and I am frequently a critic of his policies) Ontario has done pretty well on the vaccination front.

The jury is out as to whether public health outcomes more than offset economic disruption, business interruptions and failures, and damage to our children’s education arising from the seemingly endless lockdowns, restrictions on businesses and school closures. On that score, Florida is a clear winner in relation to Ontario.

Two factors are neither intensively studied or reported on by governments.

One is how many of the COVID deaths would have occurred in any event had their been no pandemic. The actuarial death rate for people over 65 years of age is 3% per year from all causes. 21% of Florida’s population is over 65 or about 4 million and expected mortality for this group would be over 13,000 without COVID. There are only 2.3 million Ontarians over 65 (16.5% of the population) so the expected mortality of the same group in Ontario is about 6,900.

The other factor that seems to be ignored is the cost- benefit of the government intervention in the name of public health. Everyone dies, so the death rate is somewhat incidental and the “lives saved” really means “lives extended” and for people who are senior citizens, the extension is a few years at best. Adjudication of wrongful death suits in Canada has seen our courts put a value on a human life of about $40,000 for adults.

If we assume Ontario’s outcomes would parallel those of Florida during the COVID pandemic if Ontario interventions had been similar to those in Florida, and adjust for the relative sizes of the populations, Ontario would have experienced 63,763 x 140/220 = 40,576 COVID deaths rather than the 11,130 recorded. Attributing that difference solely to policy initiatives, one could argue Doug Ford’s government “saved” about 30,000 lives by spending an estimated $51 billion or about $1.7 million per “life saved”.

By contrast, Florida spent about $6 billion to fight COVID.

I often hear people say “you can’t put a value on a human life” but actuaries do that every day in advising insurance companies and litigants in wrongful death suits. COVID is a serious disease and some level of public health response is warranted. But Canadian governments over-reacted and created enduring economic problems while the benefits of that reaction were both tenuous and limited.

Older people comprise the bulk of COVID deaths in Ontario with 6,547 deaths occuring in people over 80 and less than 1,000 in persons under 60. People under 60 pay the most taxes and will bear most of the burden of the $51 billion spending while people over 60 got most of the benefit. The Ontario response was an intergenerational redistribution of wealth at the expense of younger Ontarians.

I am an old man and part of the “vulnerable group” most threatened by COVID. In my opinion, Florida had a more sensible response than Ontario and the burden of federal and provincial debt we have left for our children to repay is massive and they could fairly see it as a selfish act by their elders who were willing to mortgage their children’s futures for a few more years of life for themselves.

When the data are looked at from the perspective of the cost-benefit analysis of COVID responses, Florida beats Ontario by a country mile. Our children deserved better.