A new bombshell report published in The Globe and Mail reveals that Canada's pandemic response system had been subject over the years to a variety of funding cuts and bureaucratic restructuring which made the country—and the world—significantly less prepared to protect itself from the novel coronavirus.
Canada's pandemic response system was once considered the envy of the world. Developed after the 2003 SARS outbreak wreaked havoc in Canadian cities such as Toronto, the Canadian government sought to avoid a repeat of the SARS outbreak as much as possible. Over the years, however, the Public Health Agency of Canada (PHAC) became lackluster.
One system developed by the Canadian government with the World Health Organization (WHO) was the Global Public Health Intelligence Network (GPHIN). GPHIN was developed as an early warning system to warn health officials and scientists of emerging pandemics across the world. The system had played a role in combatting the Ebola outbreak in West Africa which began in late 2013.
By the time of the coronavirus outbreak, however, GPHIN was underprepared. One key aspect of GPHIN was intelligence gathering across the globe to track the rise of new diseases and viruses before they arrive in Canada. Disease experts would be working around the clock to keep track of indicators of new health threats around the world. Such information would then be transferred to international bodies to help coordinate a global response to emerging viruses.
Over the years, GPHIN and PHAC were both subjected to administrative restructuring by the government. Such restructuring began in 2012, when the Harper government imposed budget cuts on PHAC. In an effort to make the health agency more compatible with other agencies within the government, top scientists were replaced by civil servants in the organization's bureaucracy, despite the civil servants having minimal, if any expertise in matters of public health.
Bureaucrats in Canada's pandemic response agencies were meant to be trained in pandemic response and technical expertise, but such training was never delivered. The Centre for Emergency Preparedness and Response, part of PHAC, had developed a pandemic emergency response plan in 2017, but the plan was never fully tested apart from boardroom discussions and paperwork administration.
By 2018, administrative restructuring was brought to GPHIN. The government reportedly feared that the agency was too internationally-focused, leading to the government to redirect much of the budget to domestic issues despite it providing the WHO with one fifth of their epidemiological intelligence.
The scientists involved in the agency were also clearly concerned over such restructuring, with epidemiologist Abla Mawudeku, who helped build GPHIN, writing in an email "I would like to let you know that, sadly, we have not been successful in convincing management of the critical value and role of GPHIN within and outside of Canada, and the indispensable relationship with the WHO. It is clear that today’s leadership is charting a different path that does not incorporate the long-term vision of GPHIN, and could lead to the demise of the GPHIN program."
"GPHIN has survived many obstacles, but this challenge appears to be insurmountable at this time," Mawudeku finished his email.
The administrative changes got even more detrimental, however, as the pandemic response system developed a more bureaucratic, top-down approach to governance. The department began demanding that all potential pandemic threats be approved by senior management bureaucrats before an outbreak warning could be issued. Analysts focused on outbreak surveillance were pivoted towards other areas of the agency, and hours were reduced among those who were not moved.
By May 2019, less than a year before the coronavirus pandemic began, GPHIN ceased delivering international pandemic outbreak warnings.
The greater focus on bureaucratic management did not only affect GPHIN, however. All across PHAC, scientists and doctors consistently found themselves being overruled by bureaucrats. When international conferences were held to discuss pandemic responses on a technical level, the government began sending high-level administrators rather than doctors, infuriating members of the international health community.
"I'm not reserving my words; I just don’t have any. Stunned," wrote on epidemiologist at the WHO in an email in response to the government's decision to send bureaucrats rather than health professionals to one WHO conference in Geneva. The WHO had specifically asked that only medical professionals with significant technical expertise be sent to the conference.
Another example of this was in the Global Outbreak Alert and Response Network (GOARN), which was internationally developed to track epidemiological outbreaks at a highly technical level. Rather than sending medical experts to represent Canada at GOARN committees, the Canadian government once again sent bureaucrats such as Elizabeth Gooding, who was falsely represented as a doctor until it was revealed that she simply held a master's degree in business administration. Canada was the only country on the committee which was not represented by someone with medical professional expertise.
The Canadian government had also received internal warnings from Canadian officials. Dr. David Butler-Jones, Canada's Chief Public Health Officer at the time, complained that Canada had "replaced public-health managers and analysts with generic public servants. Resources, expertise and capacity have been reduced, and expertise positioned further away from where organizational decisions are made on budget, policy, communications, programs and services, and so forth."
One specific issue which had been brought up by experts was the introduction of a president to PHAC, a position filled by bureaucrats which relegated Canada's Chief Public Health Officer position to nothing more than a spokesperson position for the agency.
Staff at PHAC had also openly worried that Canada was unprepared for a potential pandemic, which was noted in a review of the agency approved by Dr. Theresa Tam in 2018. The report warned that Canada would not be prepared for a pandemic. "For such events, we have little comparable experience, gaps in mandates, and little mobilization capacity or field knowledge," warned one subject interviewed for the report.
"Many had hoped for an agency with an independent voice speaking and advocating for the health of Canadians, not embedded in the political system," the report reads. "For many interviewees that vision was never fully realized. The agency is seen as more closely resembling a regular government department with the accompanying bureaucracy and inertia."
According to the report, the changes to PHAC were demanded by the government because "[the] initial decision to staff senior management with mostly physicians, while sound from a public health perspective, resulted in an agency that seemed poorly integrated into ‘official Ottawa’ and weakly managed."
The report ultimately warned that PHAC did not have the "expertise, trust and experience" to handle a pandemic and called upon the Canadian government to restructure the organization with scientists at the helm.
As a result of the lack of preparedness on the part of Canada's pandemic response agencies, the government was forced to rely on China for information, with experts suggesting that a functioning GPHIN could have warned the world about the emerging coronavirus weeks or months before China reported it.
Such was the role GPHIN played during the SARS outbreak in 2003, which also originated from China. "It was extremely important, because China was not forthcoming," said epidemiologist Dr. David Heymann.
Canadian officials took the words of Chinese officials at face value. The government failed to suspend flights from China in enough time after Chinese officials insisted such action would not be necessary. The Canadian government said they were "impressed" with the "efforts deployed to contain the outbreak, and the transparent approach taken by China thus far."
Had Canada's pandemic response agencies been prepared for a new outbreak, reliance on China would likely have not been an issue, and many more people may be alive today.
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