People wait in line to receive a COVID-19 vaccination shot at a clinic in Montreal, March 7, 2021, as the COVID-19 pandemic continues in Canada and around the world.Graham Hughes/The Canadian Press
A year after COVID-19 lockdowns began in Canada, federal documents show that Ottawa’s response to the outbreak was too slow, and did not adhere to past protocols set out for a crisis, a former top government official says.
Ronald St. John, who oversaw emergency preparedness for the Public health Agency of Canada between 2000 and 2007, said federal records show the government didn’t activate its response procedures quickly enough when the virus emerged.
Ottawa uses a four-level system for emergencies that dictates how the government mobilizes against a threat, and indicates how seriously the situation is viewed.
COVID-19 news: Updates and essential resources about the pandemic
COVID-19 is caused by a virus called SARS-CoV-2, and as it spread around the world, it mutated into new forms that are more quickly and easily transmitted through small water droplets in the air. Canadian health officials are most worried about variants that can slip past human immune systems because of a different shape in the spiky protein that latches onto our cells. The bigger fear is that future mutations could be vaccine-resistant, which would make it necessary to tweak existing drugs or develop a new “multivalent” vaccine that works against many types, which could take months or years.
Not all variants are considered equal threats: Only those proven to be more contagious or resistant to physical-distancing measures are considered by the World Health Organization to be “variants of concern.” Five of these been found in Canada so far. The WHO refers to them by a sequence of letters and numbers known as Pango nomenclature, but in May of 2021, it also assigned them Greek letters that experts felt would be easier to remember.
ALPHA (B.1.1.7)
- Country of origin: Britain
- Traits: Pfizer-BioNTech and Moderna vaccines are still mostly effective against it, studies suggest, but for full protection, the booster is essential: With only a first dose, the effectiveness is only about 66 per cent.
- Spread in Canada: First detected in Ontario’s Durham Region in December. It is now Canada’s most common variant type. Every province has had at least one case; Ontario, Quebec and the western provinces have had thousands.
BETA (B.1.351)
- Country of origin: South Africa
- Traits: Some vaccines (including Pfizer’s and Oxford-AstraZeneca’s) appear to be less effective but researchers are still trying to learn more and make sure future versions of their drugs can be modified to fight it.
- Spread in Canada: First case recorded in Mississauga in February. All but a few provinces have had at least one case, but nowhere near as many as B.1.1.7.
GAMMA (P.1)
- Country of origin: Brazil
- Traits: Potentially able to reinfect people who’ve recovered from COVID-19.
- Spread in Canada: B.C. has had hundreds of cases, the largest known concentration of P.1 outside Brazil. More outbreaks have been detected in Ontario and the Prairies.
DELTA (B.1.617 AND B.1.617.2)
- Country of origin: India
- Traits: Spreads more easily. Single-dosed people are less protected against it than those with both vaccine doses.
- Spread in Canada: All but a few provinces have recorded cases, but B.C.’s total has been the largest so far.
LAMBDA (C.37)
- Country of origin: Peru
- Traits: Spreads more easily. Health officials had been monitoring it since last August, but the WHO only designated it a variant of concern in June of 2021.
- Spread in Canada: A handful of travel-related cases were first detected in early July.
If I’m sick, how do I know whether I have a variant?
Health officials need to genetically sequence test samples to see whether it’s the regular virus or a variant, and not everyone’s sample will get screened. It’s safe to assume that, whatever the official variant tallies are in your province, the real numbers are higher. But for your purposes, it doesn’t matter whether you contract a variant or not: Act as though you’re highly contagious, and that you have been since before your symptoms appeared (remember, COVID-19 can be spread asymptomatically). Self-isolate for two weeks. If you have the COVID Alert app, use it to report your test result so others who may have been exposed to you will know to take precautions.
Need more answers? Email audience@globeandmail.com
Canada vaccine tracker: How many COVID-19 doses have been administered so far?
Level 1, the lowest category, is used for routine events (such as an outbreak of measles in a single jurisdiction) followed by three categories of increasing seriousness – heightened, escalated, and emergency at Level 4. According to federal documents, Level 4 is an event causing significant illness, that has the potential for rapid spread, and that requires a national response.
The system is designed to allow the government to quickly mobilize additional resources, such as personnel, expertise, and decision-making capacity, to confront the situation. Epidemiologists say timing is crucial at the beginning of an outbreak: Even a few days or weeks can have a significant impact on a country’s ability to prepare for and better contain a spreading virus, significantly reducing the death toll.
Dr. St. John said past standards dictate Canada should have elevated its response readiness to Level 2 almost immediately after the novel coronavirus became known to the world on New Year’s Eve, 2019. As the situation worsened, Canada should have moved to Level 4, the emergency activation, on Jan. 20, 2020, when cases were found in South Korea, showing international spread.
Instead, he said, Ottawa lagged. The federal documents show the Public Health Agency didn’t activate Level 2 until Jan. 15, and didn’t escalate to Level 3 until Jan. 28 – after COVID-19 arrived in Canada. Level 4 has never been declared.
“This document is a disaster,” Dr. St. John said. “This shows a lack of expertise inside the agency.”
Dr. St. John said it was important in past crises that the system moved fast, because it was designed to spur government and eliminate bureaucratic hurdles to help federal agencies prepare. For example, as the levels escalate, Treasury Board approvals needed to fund urgent response efforts can be suspended to speed actions such as shoring up medical supplies or adding scientific expertise to government ranks.
By comparison, the federal government went to Level 2 within minutes after the second plane hit the World Trade Centre on Sept. 11, 2001, given the potential need to activate the national emergency stockpile in the event of an attack in Canada. It activated Level 3 early in the 2003 SARS outbreak. Canada went to Level 4 in the 2011 H1N1 outbreak, which helped focus government resources on response and containment.
Dr. St. John said he finds it troubling the government has never seen the COVID-19 outbreak as a Level 4 threat, even today. “I am left wondering what kind of event would merit a Level 4 activation. I can’t believe that a global pandemic with millions of deaths, variants ... and on and on, would not merit continuous Level 4,” he said. “I mean, what would be a Level 4 event, the extinction of humanity?”
Responding to questions from The Globe, the Public Health Agency did not say why it delayed declaring a Level 2 event in early January, other than to suggest it didn’t believe the threshold was met. The agency said Level 4 activation occurs “when the impact of an event requires the greatest use of resources to adequately respond,” including 24/7 staffing of the Health Portfolio Operations Centre (HPOC), which is the government’s emergency hub for public health operations.
“HPOC has not activated at Level 4 during the COVID-19 event, as the required response triggers and considerations for an active 24/7 response have not been met,” department spokeswoman Anna Maddison said.
Department records, including a document produced by the office of audit and evaluation at Public Health, show the agency lacked sufficient expertise and personnel in the first several months of the pandemic, and was scrambling by fall 2020 to hire temporary staff. Scientists inside the department have also told The Globe they struggled to get urgent warnings up the chain of command due to an influx of middle managers from other departments who lacked a sufficient grounding in the basics of public health.
Quickly adding more personnel and expertise is partly what the escalating levels are designed to enable. Dr. St. John said the delays are evidence that incident management expertise has been lost inside the Public Health Agency over the years.
The system was not intended to operate on a series of triggers, he said. Rather, it’s designed to mobilize response and containment tools in advance.
“You should be, as an incident manager, trying to anticipate. And if you over-activate, that’s a lot better than under-activating. You can always dial back; it’s much harder to dial up,” he said. “They’ve set up a whole bunch of triggers that you have to meet in order to move to another activation level. Well, that’s not how it works.
“You don’t write memos saying ‘I need clinical doctors to come join my team.’ It has to be flexible.”
Vietnam, which has been praised for moving early and effectively on COVID-19, enacted strict measures, including border controls, on Jan. 11, when the first COVID-19 death was announced in China. It began formal pandemic preparations a few weeks later, more than a month before the WHO declared a pandemic.
“It’s like mobilizing your army,” Dr. St. John said. “It just tells me, over and over, there’s just this lack of public health and emergency management experience [at the agency].”
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Grant Robertson