Distanced care

An interesting read on Lithub by Maya Alexandri about being an EMT during covid.

Two men, friends of the patient, were hanging back by the entryway to the apartment building, remote witnesses to the proceedings. I couldn’t tell if they were frightened, overwhelmed, or just trying to stay out of the way

The weird loneliness of this moment.

The field guidance discouraged passengers

And also the inability to access care when you are scared and sick.

Cough and shortness of breath for an hour? We’re not even going to test him

The weirdness of triaging and limited resources.

He held his phone. He began to push numbers on his screen.

He was the first patient I transported who was suspected of having Covid-19.

Then there’s a delightful section on training and decontamination procedures and how the universe works.

Of course, with an attitude like mine, it would happen—as it did—that I was the first EMT to go through the decontamination procedure

It’s an interesting perspective. It’s also cool to be reminded that so many good writers do other things. For a long time I felt like if I didn’t write for a living I was failng somehow but these jobs make you more interesting.

Canada's cities deserve and need better

Going on Twitter has gotten even harder the last few days. In addition to the general apocalypse of the pandemic is a vulnerability that will make the lives of most Canadians much worse and harder, whether they’re as attuned to it as I am or not: city after city is announcing serious fiscal strain due to property tax payment issues and other losses of revenue.

Our cities are an overlooked level of government that in our constitution were given to the provinces rather than being made their own level of government. In Urban Nation Alan Broadbent describes Canada as a country set in amber, where that 150+ year-old decision lingers with enormous consequences. The history of Canada is very much the history of our constitution, and how well the structures it set out for us do and do not work.*

Canadian cities unlike those in many other places can do nothing without provincial consent. If they want to introduce new taxes to fund transit expansion the provincial government can make them put it to a doomed vote as happened in Metro Vancouver in 2015. Provincial leaders can interfere with and alter municipal structures as Doug Ford did when he changed the number of seats on the City of Toronto’s council midway through an election campaign. Norms made it risky but he was free to do it because municipalities are the responsibility of provinces. Toronto has long been meddled with for broader goals, which is in part why the amalgamated city exists today.

Our cities are dysfunctional by design. In part the design of many moons ago and all the unintended consequences of those choices, and in part the design of MLAs and Premiers who don’t think cities are proper levels of governments deserving the same taxation powers they and the feds get. Those same MLAs and Premiers are happy to download responsibilities as are federal governments but those increased responsibilities are not joined with the means to pay for them.

I was a political science major in undergrad. I started out thinking that international politics and federal politics were the place to be. Then I got into urban design and realized that the politics of what my street looks like were what I found the most interesting. Urban designers decide how we live and how we die in a very immediate way. Will you be active? Will you get hit by a car? Can you get where you need to go? Is there anything to do near you? How much money do you have to have to live somewhere nice?

Maybe I’m biased because I have an MSc in Urban Strategies and Design and I’m a Master of Landscape Architecture student, but cities matter a lot. Municipal austerity will make my life much worse and it will make your life worse too. Although it’ll hurt a lot more if you’re vulnerable and really need those services.

Canada’s cities make due with what they have but underperform compared to many places that have different frameworks for how their levels of government work and how things are funded.

Take transit, which is facing a critical crisis in Vancouver. Unable to borrow and not currently collecting fares Translink is in crisis and talking about deconstructing their services. Even before this horrible phrase came to dominate the future of transit in Vancouver the network was inadequate and underbuilt. Compared to many European and Asian cities our transit is quite poor. Ridership is increasing and buses are being added but investments in rapid transit (aka Skytrain) are slow. 

By comparison most towns in France could build an entire tram network in the time we’ll spend debating whether it’s worth building the extra length from Arbutus to UBC, a campus that should really be served by at least three Skytrain lines. The difference is that French cities have the power to decide to build a tram system and just build it. They don’t need to involve any other level of government. If they want to do it it happens.

In Vancouver you need four levels of government on board and that takes a really long time if it ever happens.

How do I know this? I wrote a dissertation on the Edinburgh Trams Scheme Phase I, a project marred by a meddlesome and unsupportive Scottish Parliament. The scheme started out as wonderfully ambitious and transformative, and ended in a truncated partial route with funding problems, all because upper levels of government wouldn’t let the City of Edinburgh Council do what they wanted to do, which was build a really great transit system. 

I used French cities as a case study for comparison. The lesson was obvious: when we trust cities and give them the resources they need, they build a lot of transit and quickly.

When higher levels of government view cities as vital and give them the funding they need -- either through transfers or taxation powers -- they build transit and housing and all the other vitally important things large cities need. When they don't, cities muddle along as best they can but doing way less than they need to be doing.

Before the City of Vancouver started looking at stark and painful austerity it was already underperforming because it can’t do the things it needs to be doing with the taxation powers that it has. Now that problem is about to get significantly worse. As people struggle the city will stop doing things it was barely able to do before. Cuts will be happening in cities across the country when it will hurt the most. Instead of stimulus we’ll see canceled projects and layoffs. Instead of preparing for climate change and investing in our future we’ll struggle to get back to our already underperforming pre-covid baseline.

In this moment things that weren’t possible have become possible like including self-employed and contract workers in EI. Maybe we can stop and notice how important cities are and start treating them like the vital level of government deserving of respect and expanded fiscal powers that they are. If we don’t we’ll be much worse off and this crisis will be a lot harder to come out of.

I’m scared for a future with less transit, fewer climate adaptation projects and deferred infrastructure upgrades. Our cities are vitally important and they deserve so much better.

* My intro to Canada politics professor instilled the importance of the constitution in me and this blog post would not exist without him

My dissertation cover page

My dissertation cover page