Expert: B.C. 's decision to centralize power to fight COVID-19 necessary but likely unpopular

B.C.'s decision on Thursday to suspend state-of-emergency status issued by municipalities in favour of a centralized provincial state-of-emergency is likely the right choice to effectively combat the COVID-19 pandemic - even if it is unlikely to win the province many friends among municipal circles.

That's the view of researchers with expertise in supply chains and health care operations in B.C., who added the move to ask municipalities to create an inventory of public facilities that the province can take over at any time for the purpose of combating the outbreak - while almost appearing dystopian - is a precaution that provincial health officials have to take at this point.

"When you hear this type of contingency planning, the immediate picture in your head is exactly like what you would see in a war," said UBC Sauder School of Business professor Mahesh Nagarajan. "But let's be very clear: Right now, the number of admissions to hospitals is manageable. If the [infection] rate rises at a what was being forecasted, however, we could be in for some real trouble. ICUs and emergency wards would be hammered by the influx of patients, and current hospitals will not be able to handle it. You need flex capacity."

Nagarajan added that public facilities may also be used to house medical professionals who are exposed to COVID-19 and cannot return to the general population, and yet still must have a place to sleep and eat in order to continue the fight.

B.C. solicitor general Mike Farnworth announced Thursday sweeping centralization measures, including the requirement for municipalities to comply with provincial orders of public health and safety directives. Nagarajan noted that similar measures have been put in place during times like the aftermath of 9/11, so while it is uncommon to see, such drastic moves to centralize power to deal with an emergency isn't unheard of in the West.

"This is why you centralize," he said of the province's move to collect municipal inventory on available spaces. "Big decisions like that one cannot be made in a fragmented space. It has to come from the top down."

Nagarajan added that the chaos in the U.S. medical system in dealing with COVID-19 in recent weeks shows the effects of having an opposite approach. He noted that the American health care system is heavily fragmented between federal, state, municipal and private jurisdictions, meaning there is no coordinated approach to tackle a common, widespread problem.

However, that isn't to say municipalities will be happy about the development.

"Despite what I said about the advantages of being centralized, this will cause issues," Nagarajan said. "Some municipalities will have better ideas of what resources they have, as well as how rules and regulations will affect their specific region and their stakeholders. Provincial agenda is to look after the entire province - which may conflict with the agendas that local authorities may have."

One scenario that could play out, Nagarajan said, is if one region's COVID patients can no longer be adequately housed within that region - which then requires the province to step in and open facilities in other nearby regions to house the spillover COVID patients.

Ultimately, these anxieties can be mitigated. Nagarajan added.

"As the province, you have to clearly tell all the stakeholders what you are doing, and why you are doing this," he said "There has to be transparency, and there has to be some sense of fairness to the treatment of all regions and municipalities - so that, across the board, no one is suffering a significantly larger degree of under harm. And lastly, you have to get the overall public opinion on your side."