The Global Pandemic in Saskatchewan: a history to remember

Erika Dyck and Jim Clifford

The COVID-19 pandemic tested healthcare systems worldwide and pushed many of them to the breaking point. Canadians experienced the pandemic in diverse ways depending on where and how they lived, from single-family dwellings with converted virtual workspaces to long-term-care facilities with rigorous lock-down policies or First Nations reserves with inconsistent access to potable water, but in some cases, local leaders who took public health matters into their own hands. Canadians with pre-existing health conditions faced new obstacles, and pandemic circumstances altered the regular rhythms of accessing healthcare services, leaving many Canadians delaying appointments or waiting for surgeries. These pandemic conditions exposed how deeply healthcare decisions are entangled with other public services, from education to transportation, housing and institutionalized long-term care, responses to the Truth and Reconciliation Commission, or the panoply of services combatting poverty.

Dyck’s academic home is the history of medicine, and for nearly 25 years, she has been studying the history of mental health services, including care in the community and psychopharmaceutical experimentation, examining how these changes in psychiatric care have intersected with Medicare and related political reforms. Clifford is an environmental historian who studied infectious disease and the urban water supply in nineteenth-century London. In 2020, when the scale of the COVID-19 pandemic became apparent, we put our regional and temporal differences aside and focused on documenting the historic pandemic quickly unfolding before us.

From March 2020 to the summer of 2023, we worked closely with colleagues in History and Community Health & Epidemiology and secured funding from the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research. We sought out research partners from front-line service providers throughout our home province of Saskatchewan. We conducted approximately 100 interviews with service providers and clients, tracked policy and news releases, including on social media platforms, and surveyed the population with the support of Mental Health Commission of Canada, to both archive and analyse the impact of the pandemic on health services.[1]

While our specific findings are limited to the province of Saskatchewan, several points warrant further reflection as we consider the impact of the pandemic on the healthcare system. The pandemic put tremendous pressure on the healthcare system, causing the system to crack in some acute ways, for example, as Intensive Care Units in the province reached capacity in the fall of 2021, and long-term-care facilities faced catastrophic outbreaks, but COVID-19 also revealed some remarkable strengths. Under pressure, some communities found ways to come together, setting aside ideological and organizational differences in order to prioritize public health services – including housing, food, and mental health – services that largely spill outside of Medicare’s direct influence, but whose services dramatically helped to reduce the pressure on hospital-based services. In fact, with the temporary injection of federal emergency funds during the early waves of the pandemic, some organizations managed to even more efficiently deliver services, albeit under considerable stress and duress. For example, in Saskatoon, the Food Bank, Fire Services, the Salvation Army, Prairie Harm Reduction, and the Friendship Inn came together overnight to share ideas, supplies, and human resources.

In an unprecedented effort to pivot services for some of the most vulnerable people in the community, a new consortium – Saskatoon Inter-Agency Response Committee (SIRC) – was born. With the urgency of the pandemic motivating decision makers, SIRC supported the shift to boxed and distanced food delivery that amounted to maintaining a meal schedule such that not a single meal was missed in the rapid transition to social distancing. Interviews with key leaders from these organizations suggested that the urgency of the pandemic changed the nature of front-line delivery models from one that required many meetings, consensus building, grant applications, and competition amongst organizations, to an organizational flow chart that mirrored a fire department. Instead of having to identify a fire, then apply for a grant to secure a truck and staff it with trained firefighters, the pandemic created a governing environment where frontline service providers could act decisively and cooperatively, and ultimately, efficiently.

While no one mourned the end of the pandemic, the circumstances helped to showcase some of the existing strengths within the Canadian healthcare landscape, and at the same time, it illustrated how dependent those services are on core funding. In a temporary moment when issues of poverty, houselessness, and mental illness became politicized as threats to everyone’s collective health and safety, service providers across the country stepped up to share resources, information, and later vaccines to promote better health outcomes.

Despite these successes however, the data collected from the pandemic suggest a general decline in overall well-being when it comes to mental health and addiction, food security, housing, and education. As vaccines took the edge off the worst infectious threats of the pandemic, a global recession and rising food costs coincided with a retraction of pandemic policies that provided core funding, creating or even worsening pre-pandemic conditions for many Canadians who had already struggled to secure primary care services and basic needs.

The successful rollout of the mass vaccine campaign in the first half of 2021 provides another example of the effectiveness of the Saskatchewan Health Authority during a prolonged crisis. Vaccine mandates, however, put public health officials under political pressure to weigh individual against collective concerns as the occasion tested public faith. Social pressure pushed these issues outside the bounds of clinical trials or Parliamentary debates and reminded us of the tremendous influence of social media in stimulating (mis)information about healthcare options in ways that added new grist to the ideological campaigns for and against public health care. The intense and rapid politicization of vaccines grafted onto ideological perspectives about the sanctity of publicly funded healthcare provisions. Questions of access, equity, transportability, and comprehensiveness, principles of the Canada Health Act, found direct application in the creation of vaccine passports and stimulated divisions about the meanings behind those terms.

The COVID-19 pandemic tested our services, resources, and emotional fortitude in unprecedented ways. The Saskatchewan and Canadian healthcare system withstood the pandemic and for the most part managed to provide essential care under the largest test it had faced in four decades. Yet the successes came at a cost. Residents living in long-term care facilities experienced a higher death rate and more severe restrictions, while people struggling with food and housing security, mental health and substance abuse faced new kinds of challenges accessing critical services. Surgical wait times lengthened, and healthcare staffing burnout reached an all-time high. Canadians now face a low point in our recent history regarding access to primary care, with pronounced gaps in rural and northern regions. Our healthcare infrastructure needs repair, and the damage caused by the pandemic has amplified calls for privatization and decentralization. Our research indicates that heeding these calls would be a mistake.

The pandemic temporarily created the political will to confront the relationship between health and poverty, recognizing for a moment that “we are all in this together”. The end of the pandemic, however, has signalled a return to pre-pandemic circumstances where poverty is a problem of tent cities, addictions, and racism; in short, issues that are isolated and othered, and above all, problems that do not generate the kind of political action that stimulates collective responsibility.

Further Reading:

Bagshaw, Sean M., Erika Dyck, Maya J. Goldenberg, Bev Holmes, Esyllt Jones, and Julia M. Wright. “The Humanities and Health Policy.” FACETS 9 (January 2024): 1–10. https://doi.org/10.1139/facets-2023-0093.

Erika Dyck is a Canada Research Chair in the Department of History at the University of Saskatchewan. Jim Clifford is an associate professor in the same department.

[1] Muhajarine, N., Dixon, J., Dyck, E., Clifford, J., Chassé, P., Gupta, S.D., Christopherson-Cote, C. and Team, R.R.S., 2023. Capturing and Documenting the Wider Health Impacts of the COVID-19 Pandemic Through the Remember Rebuild Saskatchewan Initiative: Protocol for a Mixed Methods Interdisciplinary Project. JMIR Research Protocols, 12(1), p.e46643