A lapse in federal leadership has left the country with no plan to keep essential services going if pandemic influenza becomes more deadly this fall, the Federation of Canadian Municipalities warns.
"The global outbreak of the H1N1 virus has exposed a serious gap in the federal government's overall pandemic preparedness strategy," Basil Stewart, the president of the federation, writes in an open letter sent Monday to federal Health Minister Leona Aglukkaq.
"Currently, there is neither a national plan, nor guidelines in place, to help cities and communities protect critical front-line workers such as police, firefighters, public transit operators, water and wastewater workers and municipal public-health professionals. This puts at risk the critical services that provide the foundation for effective pandemic response measures."
Mr. Stewart, who is also the mayor of Summerside, PEI, urged Ms. Aglukkaq to quickly call a meeting of federal, provincial and territorial health ministers to work out a plan for such essential services.
The federation, which represents the interests of more than 1,775 Canadian communities, argues that the health of workers who keep cities and towns running would be especially important during an escalation of a pandemic. Police may be needed to keep order outside hospitals or clinics. Transit workers are needed to get health workers to their jobs.
Public-health officials, employed by municipalities, have to co-ordinate the response to the disease.
The federal government created a 500-page pandemic plan for health workers in 2006. But the municipalities say it is incomplete.
Primarily, they say, it does not spell out which groups get priority access to a vaccine that is expected to go into production in November. Nor does it specify who goes to the front of the queue for anti-viral medicine, or who might get priority treatment if there is a shortage of equipment, such as the ventilators that assist flu-stricken lungs.
Ottawa is consulting with provinces and territories to determine who gets first access to vaccinations, a process that will continue until November, when the vaccine should nearly be ready for distribution.
A spokeswoman for Ms. Aglukkaq said Monday that epidemiological work on the H1N1 virus, which is continuing, "will be important in guiding the decision making on the vaccine prioritization."
But the federation says it is folly to wait until November when the flu season, which will begin in September, could be reaching its peak.
As for deciding who gets first access to treatment, Ms. Aglukkaq argues that the delivery of health care is the constitutionally determined responsibility of the provinces and territories.
The federation says a pandemic was not contemplated when the Constitution was drafted and the potential consequences transcend borders. Some members see the constitutional argument as a poor substitute for a lack of leadership.
"Canada must not limit itself to a patchwork of regional pandemic responses. Cities and communities from St. John's to Whitehorse must be assured that their citizens, and the essential services they rely on, will be protected by an effective national strategy that meets national standards," Mr. Stewart wrote in his letter to Ms. Aglukkaq.
"Only the federal government can provide the leadership and co-ordination required to achieve this objective."
Asked whether front-line workers, such as police officers and firefighters, might be among the first to be vaccinated, Arlene King, Ontario's chief medical officer of health, said Monday that nothing has been decided.
"Critical infrastructure is the basis of maintaining our social infrastructure during any kind of crisis or emergency. And that's why the prioritization process is going to be a very important one," Dr. King said at a news conference.
Dr. King was meeting yesterday in Toronto with medical health officers from across Ontario to discuss plans involving immunization, anti-viral drugs and flu-assessment centres.
Health authorities are finalizing decisions of how much vaccine the country will need, she said. That order must be placed with GlaxoSmithKline by the end of the month.