If Canada does not adopt a new approach to determining the risk posed by major outbreaks, the country could find itself struggling to confront a future health crisis, a former national security adviser says.
Margaret Bloodworth, who led an independent federal review into problems with Canada’s pandemic early warning system before the arrival of COVID-19, said the government must get better at preparing for outbreaks, including how it conducts risk assessments on the emergence of a previously unknown virus.
Speaking publicly for the first time since the review panel released its findings last week, Ms. Bloodworth said the Public Health Agency of Canada’s methods for assessing such risks – which help determine what kind of response is needed – are designed around known health threats. But the system is less effective at confronting new diseases, such as a novel coronavirus, where information can emerge rapidly and change often.
“That’s fine maybe if you’re dealing with something that’s known, like Ebola,” she said in an interview. “But when something unknown comes along, there is a risk, we felt, that it might fall between the cracks.”
The independent review of Canada’s pandemic early warning system, the Global Public Health Intelligence Network (GPHIN), flagged risk assessments as a key area to address.
The review was ordered by Health Minister Patty Hajdu after a Globe and Mail investigation last year reported on oversight problems at GPHIN, including decisions by the Public Health Agency of Canada (PHAC) to curtail key parts of its operations in 2018 and 2019 and shift resources to other areas, believing there was no pandemic threat on the horizon.
GPHIN first detected the outbreak in China on Dec. 30, 2019. But for January, February and much of March last year, the government’s official risk assessments repeatedly said the virus posed only a low threat to Canadians, even as it was spreading quickly around the world and overwhelmed health care systems in other countries.
COVID-19 has now killed more than 26,000 people in Canada.
GPHIN’s warning and surveillance activities are one link in a chain of systems designed to help Canada respond to a threat, including when to enact containment measures such as physical distancing, tighter border controls and so on. The panel saw the risk assessments within PHAC as an area where a breakdown appeared.
“It was not just about fixing GPHIN … that was our mandate to look at GPHIN, but GPHIN’s mandate is to produce a signal that somebody should pay attention to. That’s what it’s all about,” Ms. Bloodworth said. “They’re in the business of getting it to someone who should pay attention to it.”
The panel has recommended the creation of a specialized risk-assessment office at PHAC. Ms. Bloodworth, who served as deputy minister of transport during the Sept. 11 terrorist attacks on the United States and later as national security adviser to Stephen Harper, said the new office would help PHAC’s surveillance operations work more closely with Canada’s security and intelligence organizations.
“Intelligence can be bits and pieces of information,” she said. “But you need someone who brings it together … you need somebody – it’s not just one person, it’s an office – that is actually following those kinds of things and adjusting the risk assessment as the facts change.”
Though the panel found that GPHIN did detect the outbreak on Dec. 30, 2019, in the city of Wuhan, that doesn’t mean “OK, everything’s fine” with the early warning system, Ms. Bloodworth said.
“That’s not what we’re saying. … There clearly were problems, particularly earlier in 2019.”
But the panel’s mandate did not extend to analyzing the government’s overall response to COVID-19 during the first several months of 2020, when Ottawa told Canadians the risk was low. “The actual response and what happened and whether they should have done more, sooner, or whatever, was not in our mandate. We didn’t look at any of that,” Ms. Bloodworth said.
“But looking at GPHIN, we certainly found risk assessment to be within our mandate. Because it’s directly related to what you do with what you get out of GPHIN.”
A separate independent report, conducted for the World Health Organization by an international panel and published in May, declared February 2020, a “lost month” when dozens of countries should have been doing more to prepare but instead misjudged the threat.
Ms. Bloodworth said it’s impossible to speculate about how things would be different if Canada’s pandemic preparedness and response systems had operated how they were intended to work – including GPHIN, which had its international alert functions silenced in early 2019, causing its surveillance activity to deteriorate.
“That’s probably an impossible question to answer,” Ms. Bloodworth said. “Let me say the obvious thing: You never know what you don’t know.”
Canada was an innovator in the 1990s when it created GPHIN, which was built to scan the internet for signs of outbreaks. It became more sophisticated over time by deploying artificial intelligence to scan medical data, news reports and social media and was credited for tracking outbreaks such as H1N1, Ebola and SARS. Governments around the world are now racing to build similar systems. The Biden administration has announced plans to build a version of GPHIN in the U.S., while Germany and the WHO are teaming up on an operation in Berlin. As this capacity expands, Ms. Bloodworth said Canada needs to have a seat at the table – and for these networks to work together.
“We have a kind of card to get to the table with these other countries to talk about this. We have some credibility. We need to leverage that to make sure that we get the benefit of what they’re doing,” she said. “As a middle-power country, we gain more than we lose.”
Richard Fadden, another former national security adviser to Mr. Harper and Prime Minister Justin Trudeau and a former director of the Canadian Security Intelligence Service (CSIS), recently said in a column in The Globe that a national public inquiry is needed to review how Canada handled the pandemic and what could have been done better. Ms. Bloodworth did not dismiss the idea, but she said inquiries can get bogged down and some improvements are more urgent.
“I’m often of two minds about public inquiries. They can do very good things, but they also can be reasons to delay doing anything. And they can take a long time,” she said. “I would hate to see the country five years from now still waiting for the report of the public inquiry on the response to COVID to do anything. I’m not saying that would happen, but I do think we have to be careful.”
The independent panel also included Paul Gully, a public health doctor and former deputy chief medical health officer, and Mylaine Breton, a professor at Université de Sherbrooke who specializes in health care governance. The report is being reviewed by Ms. Hajdu, who said she welcomes the recommendations. Though Ms. Bloodworth doesn’t expect all of them to be adopted, she will consider the report a success if it changes Canada’s approach to health threats.
“Nobody ever accepts all the recommendations,” she said, adding that if, four or five years from now, “things are done significantly different than they are now, I will consider it’s been a success.”
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