Case spotlight: Dr Bonnie Henry: Contending with COVID-19 in Visible Minority Communities

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This case was featured in the June 2022 issue of Connect.

Who – the protagonist

Bonnie Henry, Provincial Health Officer of the Canadian province British Columbia (BC).

What?

During the first wave of COVID-19, Dr Henry had proven to be one of the most effective public health officials in the world, as she became the face of BC’s pandemic response, with her calm demeanour and decisive action to impose strict guidelines early on in the pandemic.

Such was the impact of Dr Henry’s decisive leadership, BC had the lowest number of per capita deaths worldwide at one stage.

Rapid test

Why?

By 30 October 2020, BC had entered a second wave of COVID-19 as over 800 new cases had been reported in the province.

Alarmingly, 81% of cases had occurred in the Fraser Health region of BC, which accounted for only approximately 40% of the province’s population.

A report by Canada’s national statistical office found that neighbourhoods in BC that were visibly at least 25% minority were nearly ten times more likely to have COVID-19-related deaths than neighbourhoods that were visibly less than 1% minority.

Dr Henry was worried by the cities of Surrey and Burnaby in the Fraser Health region, as each had visible minorities making up 58% and 64% of their populations respectively.

Some medical professionals commented on BC’s standardised communications approach for all parts of the community, while members of the visible minority communities vented their frustration on Twitter over the province’s seemingly Anglo-centric public health messaging.

When?

On 28 January 2020, BC became the second Canadian province to confirm a case of COVID-19. By 17 March 2020, 186 cases had been confirmed and Dr Henry declared a provincial public health emergency.

In early June 2020, much of BC society had opened up again and there were only 207 active cases, which was the lowest number since the public health emergency had been declared on 17 March.

But after a summer of relaxed guidelines and eased restrictions on physical distancing, a second wave of COVID-19 hit by mid-October, with a record 2,324 active cases in BC.

Where?

BC is Canada’s third largest province with approximately 5.1 million people living there.

Fraser Health, based in lower mainland BC, is one of five regional health authorities in the province, and is responsible for the distribution of hospital and community-based health delivery to over 1.9 million people in 20 diverse communities.

Key quote

“It’s not one approach fits all. Strategies that are designed for an Anglo-centric White community may not resonate with a Punjabi community or a Filipino community or a Chinese community…We need to make sure our leaders – elected and public health – touch base with the communities that are affected.”
Dr Birinder Narang, Family Physician and Global BC Medical Contributor.

What next?

As cases and deaths were again surging in October 2020, Dr Henry had gone from being called a hero to facing criticism and death threats for how she led BC through the pandemic.

How should Dr Henry connect with the hardest-hit communities? To whom should she reach out to in order to better understand the communications needs of visible minority communities? What message(s) should be delivered and through what channels? Was Dr Henry the best person to deliver the message(s)? The lives of BC residents were in her hands.

AUTHOR PERSPECTIVE 

Reaching different sections of society

Jana said: “Because Canada is a multicultural country, we were particularly interested in how governments reached out to different populations to communicate important health information.

“In an age where Diversity, Equity, and Inclusion (DEI) has become a prominent issue in society, I was particularly interested in the questions: What should governments do to ensure that everyone is included in important government messaging? Would a ‘one-size fits all’ communication approach reach members of visible minority communities? There is also a critical leadership consideration here; Who’s job is DEI? Should government leaders also be focused on how to make their communication to the general public inclusive – especially during a crisis? And how best do this?”

diversity equality inclusion

Challenges of writing a COVID case

Jana added: “One of the challenges when writing the case was the nature of constantly changing information due to COVID and its different waves. Knowing when to cut the case in terms of timeline was a challenge in itself.”

Connecting to the subject

She explained: “One of the exciting things about this case is that it allows students to delve into the population makeup of the lower mainland in British Columbia and see how COVID affected the different populations in the region.

“It forced students to question why particular areas had a higher incidence of COVID and ask the question; What is it about the messaging from the government that was not reaching these communities?

“One of the things I found interesting is that students were able to talk about their memberships in these populations and give insights into how the different groups received the government communication at the time. Students shared their lived experiences during our class discussion, thus broadening our understanding of the challenges of communicating to a diverse population, especially in times of crisis. 

“We also used the case with experienced leaders in the public sector – they were highly engaged in the case discussion in part because they lived through similar experiences which presented real challenges to them and their stakeholders.

“The case is seen as timely and relevant – and the next pandemic might be around the corner. Thus, distilling the lessons embedded in the case is seen as important from a personal and professional point of view.”

Take your time

Jana commented: “In class we suggest allowing enough time for the assignment – to build a comprehensive communications plan and take the role of advisor to Dr Bonnie Henry. And to look into the communities; and the demographics as well as the dominant beliefs and values. Designing a detailed communications plan – after an in-depth presentation of what a good plan looks like – is an important exercise in particular for people operating outside of communications. For example, it forces people to put themselves into shoes of marginalised and/or racialised groups.”

The making of a good case

Jana concluded: “Structure your case as a narrative. A good business case should read like a story. As in any good story, the characters are developed to help the reader imagine who these people are, how they might feel, and empathise with their struggles. A good case provides the reader with vivid details and descriptions and presents a compelling problem with roots in real business problems. Using narrative structure makes the case engaging for the reader and brings your teaching goals to life if done correctly.”

THE CASE 

The case

Who – the protagonist

Bonnie Henry, Provincial Health Officer of the Canadian province British Columbia (BC).

What?

During the first wave of COVID-19, Dr Henry had proven to be one of the most effective public health officials in the world, as she became the face of BC’s pandemic response, with her calm demeanour and decisive action to impose strict guidelines early on in the pandemic.

Such was the impact of Dr Henry’s decisive leadership, BC had the lowest number of per capita deaths worldwide at one stage.

Rapid test

Why?

By 30 October 2020, BC had entered a second wave of COVID-19 as over 800 new cases had been reported in the province.

Alarmingly, 81% of cases had occurred in the Fraser Health region of BC, which accounted for only approximately 40% of the province’s population.

A report by Canada’s national statistical office found that neighbourhoods in BC that were visibly at least 25% minority were nearly ten times more likely to have COVID-19-related deaths than neighbourhoods that were visibly less than 1% minority.

Dr Henry was worried by the cities of Surrey and Burnaby in the Fraser Health region, as each had visible minorities making up 58% and 64% of their populations respectively.

Some medical professionals commented on BC’s standardised communications approach for all parts of the community, while members of the visible minority communities vented their frustration on Twitter over the province’s seemingly Anglo-centric public health messaging.

When?

On 28 January 2020, BC became the second Canadian province to confirm a case of COVID-19. By 17 March 2020, 186 cases had been confirmed and Dr Henry declared a provincial public health emergency.

In early June 2020, much of BC society had opened up again and there were only 207 active cases, which was the lowest number since the public health emergency had been declared on 17 March.

But after a summer of relaxed guidelines and eased restrictions on physical distancing, a second wave of COVID-19 hit by mid-October, with a record 2,324 active cases in BC.

Where?

BC is Canada’s third largest province with approximately 5.1 million people living there.

Fraser Health, based in lower mainland BC, is one of five regional health authorities in the province, and is responsible for the distribution of hospital and community-based health delivery to over 1.9 million people in 20 diverse communities.

Key quote

“It’s not one approach fits all. Strategies that are designed for an Anglo-centric White community may not resonate with a Punjabi community or a Filipino community or a Chinese community…We need to make sure our leaders – elected and public health – touch base with the communities that are affected.”
Dr Birinder Narang, Family Physician and Global BC Medical Contributor.

What next?

As cases and deaths were again surging in October 2020, Dr Henry had gone from being called a hero to facing criticism and death threats for how she led BC through the pandemic.

How should Dr Henry connect with the hardest-hit communities? To whom should she reach out to in order to better understand the communications needs of visible minority communities? What message(s) should be delivered and through what channels? Was Dr Henry the best person to deliver the message(s)? The lives of BC residents were in her hands.

AUTHOR PERSPECTIVE 

Author perspective

Reaching different sections of society

Jana said: “Because Canada is a multicultural country, we were particularly interested in how governments reached out to different populations to communicate important health information.

“In an age where Diversity, Equity, and Inclusion (DEI) has become a prominent issue in society, I was particularly interested in the questions: What should governments do to ensure that everyone is included in important government messaging? Would a ‘one-size fits all’ communication approach reach members of visible minority communities? There is also a critical leadership consideration here; Who’s job is DEI? Should government leaders also be focused on how to make their communication to the general public inclusive – especially during a crisis? And how best do this?”

diversity equality inclusion

Challenges of writing a COVID case

Jana added: “One of the challenges when writing the case was the nature of constantly changing information due to COVID and its different waves. Knowing when to cut the case in terms of timeline was a challenge in itself.”

Connecting to the subject

She explained: “One of the exciting things about this case is that it allows students to delve into the population makeup of the lower mainland in British Columbia and see how COVID affected the different populations in the region.

“It forced students to question why particular areas had a higher incidence of COVID and ask the question; What is it about the messaging from the government that was not reaching these communities?

“One of the things I found interesting is that students were able to talk about their memberships in these populations and give insights into how the different groups received the government communication at the time. Students shared their lived experiences during our class discussion, thus broadening our understanding of the challenges of communicating to a diverse population, especially in times of crisis. 

“We also used the case with experienced leaders in the public sector – they were highly engaged in the case discussion in part because they lived through similar experiences which presented real challenges to them and their stakeholders.

“The case is seen as timely and relevant – and the next pandemic might be around the corner. Thus, distilling the lessons embedded in the case is seen as important from a personal and professional point of view.”

Take your time

Jana commented: “In class we suggest allowing enough time for the assignment – to build a comprehensive communications plan and take the role of advisor to Dr Bonnie Henry. And to look into the communities; and the demographics as well as the dominant beliefs and values. Designing a detailed communications plan – after an in-depth presentation of what a good plan looks like – is an important exercise in particular for people operating outside of communications. For example, it forces people to put themselves into shoes of marginalised and/or racialised groups.”

The making of a good case

Jana concluded: “Structure your case as a narrative. A good business case should read like a story. As in any good story, the characters are developed to help the reader imagine who these people are, how they might feel, and empathise with their struggles. A good case provides the reader with vivid details and descriptions and presents a compelling problem with roots in real business problems. Using narrative structure makes the case engaging for the reader and brings your teaching goals to life if done correctly.”

THE CASE 

The protagonist

Bonnie Henry
Provincial Health Officer of British Columbia
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