Wednesday, September 03, 2003

Learning from the fires: what happens next
By Paul Willcocks
VICTORIA - A friend called from Kelowna, 12 hours before the fires swept through more than 200 homes. He is middle-aged, calm; his home was in no danger.
But the awe and fear in his voice came through the phone line. The sight of the flames against the night sky had shaken him.
As I write this the fires have eased, at least briefly. It's time to begin considering what comes next.
There's been an obvious financial impact on the government, and the people of the province.
Firefighting costs will top $200 million this week, and have been climbing at up to $7 million per day. On top of those costs, emergency aid has cost about $30 million so far, and is running about $1 million a day.
The government had budgeted $55 million for firefighting this year, so Finance Minister Gary Collins has an obvious problem.
He says the province still has the flexibility to deal with the overruns. There's a $170-million contingency fund, intended to cover all the unexpected spending by ministries. Collins has also set aside a $500-million 'forecast allowance,' a super cushion to let the government come in on budget even if things go wrong.
But the contingency fund, for all ministries for an entire year, is gone before the fiscal year is half over. And a big bite will be taken out of the forecast allowance.
The budget calls for a $2.3-billion deficit this year. Given Collins' conservatism, most observers would have expected the target to be beaten by more than $500 million. That looks much less likely.
The other question is how badly the fires will hurt the economy. Some 3,000 forest workers are off the job already, barred from tinder dry woods. Sawmills are running out of logs, and unless the situation improves the job losses could mount with each week. (The fear of lost production has pushed up prices, so mills in other areas should be more profitable.)
Tourism is taking an immediate hit. People who planned a houseboat trip on the Shuswap are hesitating. Americans considering a trip to B.C. are staying home. That's business that won't be recaptured.
The larger question is whether there will be a lasting impact on tourists who fear that B.C. has become a less attractive destination. A special tourist marketing campaign will be needed to cope with the fallout from SARS and the fires.
So far, the focus has been on fighting the fires and helping the dispossessed. Desperate people have celebrated the efforts of firefighters and the visits by politicians.
But once the smoke has cleared, an independent inquiry is badly needed.
Fires are part of life in a forested province, where people want to live among the trees. But B.C. has been much less active in clearing fallen trees and other wood waste from forest floors than other jurisdictions. The province's auditor general warned two years ago that years of successful efforts to reduce small fires had allowed a dangerous concentration of fuel, setting the stage for much large blazes.
And he warned that B.C. was ill-prepared, offering a number of specific recommendations to avert disaster, or at least reduce its cost.
Progress on his recommendations has been slow. Even Liberal MLAs complained a year ago that too little was being done by the government. (For example, Solicitor General Rich Coleman created a provincial fire department in response to these blazes; the auditor general warned two years ago that such a change was needed.)
Along with the inquiry, there will have to be extraordinary help for the people and communities involved. The federal and provincial governments have a disaster relief formula. But finding homes for hundreds of families and helping communities cope with lost infrastructure will strain the normal programs.
Fires, even terribly damaging fires, may be part of life in B.C. But we need to be sure that we are doing everything reasonable to manage the risk. And independent inquiry will help make sure that happens.
Footnote: The first political pressure point will likely be compensation. Premier Gordon Campbell says the province will ease a policy which denies compensation to people who could have bought insurance, but expect some conflict.

Sometimes people just die and it's not a medical crisis
By Paul Willcocks
VICTORIA - It's time we thought a little harder about how significant it is that 4,000 people died in France during a heat wave, or that eight people died in a Surrey nursing home after a 'SARS-like virus' struck.
People get edgy if you suggest some deaths matter more than others.
But they do.
Take the emergence of a mysterious virus at the Kinsmen Place Lodge in Surrey. Eleven people have died since the outbreak began six weeks ago, out of about 150 people at the home. That sounds pretty serious.
But in a typical month at the lodge, four or five people die. The residents are old, and many are unwell. The number of deaths even potentially linked to the disease is smaller than it may appear.
The normal rate of five deaths a month means 60 people die at the facility in a normal year. The average lifespan for someone admitted to the lodge is thus something like 2.5 years.
And that means that the three additional deaths in recent weeks have resulted in something like 7.5 years of life lost.
That's not a measurement most of us use, although actuaries, insurance companies and public health officials are all keenly interested. But we should. A disease that claims healthy young victims robs them of decades; an infection in a nursing home that strikes the most vulnerable may simply mean death comes a few months early.
I'm not questioning the significance of the loss for the families involved.
But it's a matter of math. Car crashes among 15 to 24 year olds claimed 85 British Columbians in 2000, with an average loss of 55 years of expected life for each victim. Three extra deaths mean something like 155 years of life lost. Those deaths are more significant -- for society, the economy, family.
The equation will be much the same in France, where the government -- and families -- has been much criticized for the deaths of up to 5,000 people in the current heat wave, many of them elderly or sick.
If there has been neglect, or a failure to act, then that is shameful. If there are public health lessons to learn, we should heed them.
But we should also be open to the possibility that for many victims, already weakened, death within months was almost certain. The heat wave may have advanced the end, but not by much.
That doesn't mean, again, that we should do nothing about the illness or environmental problems that kill the old and the sick. Life has value, at 90 or at nine.
But it doesn't have equal value, especially given the limit on available resources and the apparently inexhaustible supply of new, costly treatments.
We are all going to die. By the time we are somewhere like the Surrey lodge, we are going to die fairly soon. And it's time to shed the notion that all deaths, or illnesses, call for the same response.
We aren't close to coming to that realization. A major U.S. study found that 27 per cent of health care expenditures in California and Massachusetts went towards patients in the final 12 months of their lives.
The figure for B.C. is similar, which means about $2.7 billion will be spent on 28,000 people who will die in the next year, or $100,000 each. The average expense for the rest of us will be about $2,100 each.
That's not necessarily wrong, if the spending is wise, bringing comfort to a person's final months or a real chance of success.
But the same study found one in eight patients over 85, with cancer unresponsive to chemotherapy, had received the costly and unpleasant treatment in the last three months of their lives.
To what end?
It's not our job to consign people to death once they pass a certain age.
But it is our job to make intelligent, rational decisions about how we try to deal with the real world of health challenges, whether it's in a Surrey nursing home or a Paris apartment.

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