Reflecting on COVID, how we’ve changed, what it took to get through a demanding year, science deniers, vaccines, and what 2021 holds for Nova ScotiaR
obert Strang didn’t set out to be a doctor.
During his undergraduate degree in kinesiology and masters in exercise physiology, his curiosity prompted him to consider medicine.
“I was fascinated by how your body works and especially as it relates to exercise,” Dr. Strang recalls. “I really like learning anatomy and physiology, but how you practically use that… How do you make a difference in the world? And so putting those two together got me thinking about medicine.”
After completing medical school, Strang found his passion during his family residency. It led him to complete a specialty in preventative health and medicine.
Now, Strang has the weight of the province on his shoulders as its Chief Medical Officer of Health. He’s been the face of Nova Scotia’s COVID-19 pandemic response. It’s not his first pandemic. Coming into COVID-19, he could fall back onto his experiences from overseeing responses to H1N1, SARS, and Ebola.
Strang explains that the 2009 H1N1 pandemic was much less complicated because health officials knew a lot about the virus and the vaccine.
“The last big pandemic was 100 years ago, so society was incredibly different,” Strang says. “Knowing at a very high level what it could be like… I don’t think until you are really in it, see all the complexities, intricacies and how it went from a public health event to a health event to a societal event within a space of a couple of months. Until you are in it, I don’t think anybody can truly understand the breadth and depth of all the issues that would unfold.”
Strang and his team spoke with public health colleagues from coast-to-coast, gathering information to make quick decisions that would impact every aspect of the province.
Strang recalls how people that work in health care—including labs, primary care testing centres, hospitals, and government groups—stepped up for a collaborative response to the health crisis.
That response had a rippling effect on the economic, social, and communal aspects of Nova Scotians’ lives. “People have said, “We understand it’s necessary, and we’re trying to get on board do what we need to do to keep each other safe,” says Strang.
He adds that people should take pride in how we’ve adapted.
“That whole sense of collaboration being in this together and a sense of community that’s evolved out of this in many ways that I’ve seen are wonderful things that we can be proud of,” Strang says. “There are some interesting innovations, like how we move forward rapidly with things like virtual care in the health care system. We’ve had different models of how we support people that are homeless during the first wave and having a more hotel model rather than shelters.”
Strang represents a large team, with a variety of experience and expertise.
“There are hundreds of people, first on my team and the department of health and wellness, public health across the province and in the whole health system,” Strang says. “They are… working extremely long hours, being very creative and innovative. It’s so encouraging how everybody has come together and done what’s necessary, many problems big and small, and kept things moving forward, all the while staying together and focused on our collective work around COVID in a very positive way. we talk through things, discuss all the evidence, all the implications, make decisions together and they’re amazing.”
Strang hasn’t had what you could call an “ordinary day” for the past 11 months. His daily routine starts with a review of the many emails that arrived overnight. The day is chock-full of teleconferences, virtual meetings, and briefings with Premier Stephen McNeil in preparation for media updates and follow-ups.
“I want to thank Dr. Strang, as he’s been working very hard with every department with putting in great protocols,” McNeil said in a mid-December press conference. “I want to give a shout out to public health: Dr. Strang and his team has been doing tremendous work… On behalf of all Nova Scotians over the last 10 months: thank you for the work you have been doing and your teams across the province.”
It’s all in a day’s work. “My job is to understand all of the different pieces knowing that there are teams of people involved in the details of all those pieces,” Strang explains. “My day is making sure I’m touching bases with all the places that I need to so I am up to date and provide input. Ultimately, things come to me to either make decisions or to bring forward for others to make decisions on.”
The work usually continues into the evening. “I’m not able to do things that I should be doing, especially being physically active to keep myself healthy I could be as well as time away from work to be mentally healthy, but I’m doing okay,” Strang says. “My family has put up with lots of me, not nearly being as available as I should be as a husband and a father, and I thank them for that.”
But he does make time for local good causes. Recently, he helped raise money for the Make-A-Wish Foundation by rappelling down 15 storeys of the Westin Nova Scotia. He visited seven-year-old Hughie Dauphinee after learning his young fan was born with a cleft palate. Also, he donated ties worn during the pandemic media briefings to decorate a Christmas tree that raised $8,000 for the Mental Health Foundation of Nova Scotia.
“That’s just me walking the talk,” he says. “I always talk a lot in my briefings that we all need to take care of each other to build a positive community. I believe that’s fundamentally important, and it’s even more important that what people see me doing, that actions speak louder than words. It is the right thing to do, and hopefully, my example is encouraging people as well.”
During the COVID-19 pandemic, the Chief Medical Officer has been in a difficult spot when making decisions on restrictions. Those have included places of worship, sports, and recreation. Additionally, Strang knows people in this province hope for a late Christmas miracle: restrictions lifted for family gatherings during the holiday season.
He hopes that people will look at how these restrictions will benefit the province in the long run. It’s also a balancing act about finding that common ground between minimizing the impact and making the right decision that protects individuals. None of the decisions have been lightly, but for Strang, he must consider the vulnerable populations and communities.
“All of these are recognizing the importance of faith and faith gatherings, whether it’s sports and recreation, arts and culture, those are what make our society vibrant and support that people practice their faith,” Strang says. “Things have to be different. Ultimately, it’s finding a way to allow those to continue as much as we can. When we have to stop, hopefully, we are only be stopping them for a short amount of a time as necessary.”
Since the pandemic began, Strang and Premier Stephen McNeil have appeared together to update media. The Chief Medical Officer’s role isn’t political and Strang says he has never felt constrained or pressured to make a politically expedient decision.
“The premier is ultimately elected to lead this province… he’s always put the health of Nova Scotians first,” Strang says. “He listens when I give advice. I think that’s one of the fundamental successes that we have in Nova Scotia, unlike certainly in other countries, even in other provinces and territories, where there’s been more politicization of this event. We’ve been able to work together to put… protecting the health of Nova Scotians at the forefront.”
That doesn’t mean there aren’t disagreements, as everyone at the table has different priorities. “There are little things you have to work through, but there’s agreement on what we’re doing and why,” Strang says. “It’s the key to our successful response and building a trusting relationship through all of this with Nova Scotians.”
There’s been little public criticism of Nova Scotia’s response, with most objections coming from science-deniers, like the people opposed to vaccines and mask-wearing. “It’s absolute nonsense,” Strang says. “People need to understand [those beliefs] for what they are and how very harmful they can be. Hopefully, the vast majority of people are trusting what public health and the governments are putting forward because we plan to protect Nova Scotians.”
2021 will be just as busy for Strang, as the COVID vaccination program ramps up. And the risk of new waves of sickness continue.
“We remain focused on that with our combination of very innovative approaches to testing,” Strang says. “I do believe we are leading the country in many ways combined with public health follow-up around cases and contacts looking at how we use the restrictions in a limited way but being able to act very quickly and firmly when needed.”
And the vaccine doesn’t mean a reprieve from those public health precautions. “That will continue to be our approach over the next six to 12 months while we roll out the vaccine and see what role the vaccine plays in being able to have a different approach,” Strang says. “We don’t know what or where COVID will be and ultimately play a role in our ongoing infectious world and infectious diseases. We have to stick with what we’re doing, add in the vaccine, and hope for the best as we get through 2021.”
And when COVID is just a memory, Strang plans to still be there. He says he isn’t considering retiring or leaving his role as Chief Medical Officer.
He’ll likely always remember the year he became an unexpected Nova Scotian folk hero.
“I want to thank everybody because the vast majority of people have stuck with this no matter how difficult it has been,” Strang says. “They have believed in the messages that we need to do what we can to appropriately control COVID because that’s how we keep each other safe… We should approach 2021 with a sense of hope. It still won’t be easy, and it’s going to require a lot of patience, but we should be looking forward to the future with hope.”