Tam criticized for supporting ‘indefensible’ assessment of COVID-19 risk

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An expert who worked on the Auditor-General’s report that criticized Canada’s lack of preparation for COVID-19 says the government’s risk assessments were “an utter failure” and cannot be defended.

Wesley Wark, an adjunct professor at the University of Ottawa who analyzed the risk assessments during the onset of the outbreak, said Chief Public Health Officer Theresa Tam’s remarks last week that sought to justify those assessments are “defending the indefensible.”

At a news conference on Friday, Dr. Tam asserted that Public Health’s determination early last year that COVID-19 posed only a low risk to Canada was accurate in that moment, even though the Auditor-General found the methodology used to reach that conclusion was flawed.

“It was not wrong,” Dr. Tam said. “The domestic risk at that moment in time for the cases in Canada was relatively low.”

However, Mr. Wark, who specializes in security and intelligence, said the comments from Dr. Tam are misleading because they don’t encapsulate how off-target Ottawa’s risk assessments were, according to the evidence.

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Auditor-General Karen Hogan said in her report Thursday that Public Health’s tool for determining the risk COVID-19 posed to Canada was not appropriate, because it did not involve forecasts of pandemic spread, or forward-looking projections of danger. It only looked at whether the virus was present in Canada, or how many domestic cases there were, when the risk assessments were made.

That meant as the spread of the virus began to accelerate globally, with case numbers exploding in other countries, hospitals filling up and deaths mounting, Ottawa’s risk assessments focused on Canada at that moment in time. They didn’t take into account the worsening international picture and uncontrolled spread of the virus. As a result, throughout January, February and into March, the government repeatedly told Canadians that the virus posed only a low risk to the public.

“Bottom line is that [Public Health’s] risk assessments were an utter failure and cannot and should not be defended,” said Mr. Wark, who served on the advisory committee to the Office of the Auditor-General in its preparation of the report.

The Auditor-General’s report on pandemic preparedness was scathing and called on Public Health to replace the flawed tool with more credible and timely methods of assessing a pandemic threat.

In response to the findings, Public Health has pledged to review the methodology by the end of next year.

Dr. Tam acknowledged the Auditor-General’s finding that risk assessments should evaluate incoming risks, not just the present status of the virus inside Canada. Public-health agencies “need to be prediction organizations and not just being able to assess the risk of that present moment,” she said.

But Mr. Wark said the agency’s defence of its risk assessments, including Dr. Tam’s comments Friday, contain “a good deal of obfuscation” rather than confronting the problem, which was akin to Canada having blinders on until the outbreak landed on its doorstep.

In the years leading up to the pandemic, Public Health’s guiding documents put prevention and control of infectious disease as a core responsibility, requiring the agency to anticipate the impact of a pandemic on the community and health care systems.

“Far better to acknowledge that serious mistakes were made and get on with the job of making changes.” Mr. Wark told The Globe and Mail.

Opposition MPs on Friday called for an emergency meeting of the House of Commons health committee, citing the Auditor-General’s report as the top reason. The letter, signed by the Conservatives, Bloc Québécois and NDP, seeks a meeting this week and for Health Minister Patty Hajdu and Dr. Tam to appear before committee by April 7.

The Auditor-General’s report leaves “no doubt that PHAC has seriously let down Canadians,” NDP MP Don Davies said in a statement Sunday. “We need acknowledgments and solutions, not denials and excuses. We also need full accountability. It’s time the minister took responsibility for this failure.”

Conservative MP Michelle Rempel Garner said in a statement that the low-risk assessment contributed to confusing and conflicting advice from the government. “Eroding public confidence in health advice at a time when confidence is crucial has dangerous consequences and suggests that the government doesn’t have the capacity to correct critical errors because they won’t acknowledge that they exist,” Ms. Rempel Garner said.

Mr. Wark said Public Health officials made several statements last year that incorporated a forward-looking view, but still deemed the outbreak a minimal risk. Dr. Tam told the House of Commons on Jan. 29, 2020, that “Canada’s risk is much, much lower than that of many countries. It’s going to be rare, but we are expecting cases. … We are preparing the whole country in the event that you might pick up a rare case.”

He said that amounts to a faulty assessment. “It was still predictive. It was just making bad predictions,” Mr. Wark said.

“The problem with the risk-assessment methodology applied by PHAC was that it essentially refused to extrapolate from the global picture of COVID’s impact despite the wide availability of reporting from reliable authorities.”

The risk assessments were also sporadic and lacked detail. One such assessment on Feb. 2 did not mention that the World Health Organization had declared a Public Health Emergency of International Concern on Jan. 30, Mr. Wark said. That step, among the most urgent tools the WHO has at its disposal, is intended to warn the international community of serious implications.

Mr. Wark said it appears Ottawa did not update its risk assessment between Feb. 2 and Feb. 28, despite the rapid global spread of the virus. “That, in itself, was a serious failure,” he said.

Ottawa eventually declared COVID-19 a high risk to Canada on March 16, five days after the WHO warned that it had become a global pandemic.

The Auditor-General examined meeting minutes from the agency’s two key pandemic response committees and found “little discussion concerning the ongoing low-risk rating for COVID-19″ before March 12.

At that point, “in light of escalating case counts,” senior health officials raised the need for aggressive public-health measures, including mandatory quarantine of international travellers. On March 15, Dr. Tam requested that the risk assessment be elevated.

Though the threat level was raised the following day, Mr. Wark said the agency’s daily situation reports, which are distributed throughout the government, did not incorporate that change for the remainder of March, which appeared to be another troubling oversight in the process.

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