Adrian Levy is a professor in the Department of Community Health and Epidemiology at Dalhousie University.
“The appropriate time is now.”
That was my analysis in November, 2021, 18 months into the COVID-19 pandemic, responding to then-federal health minister Patty Hajdu’s assertion the previous April that a full investigation into Canada’s pandemic response would be warranted at an “appropriate” time. A year and a half and two health ministers on, we’re still waiting.
As part of the BMJ’s Canada COVID series, published in July, 20 Canadian health advocates, researchers and medical educators called for an independent national inquiry “to review Canada’s COVID-19 response, draw lessons, and ensure accountability for the past and future pandemic preparedness.”
But it appears, since the pandemic emergency has been declared over by the World Health Organization, the useful window of opportunity for such an inquiry has closed. The urgency that once existed has vanished. Given the pace of the government’s response to date, an inquiry might take years to report, rendering its findings obsolete.
Yet there is compelling evidence that biosecurity threats are mounting, fuelled globally by excessive deforestation, urbanization, and industrialization.
Despite this acceleration, and a broad awareness that all levels of government in Canada were caught flat-footed at the onset of COVID-19, officials appear to have grown complacent.
In a December, 2022, interview with The Canadian Press, Chief Public Health Officer Dr. Theresa Tam issued a call to action: “[The COVID-19 pandemic] is one of the most teachable moments, I think, in our collective lifetimes,” she said. But while Canada had done well in “ratcheting up [its] response” to COVID-19, “prevention and preparedness” had not yet become a clear priority, she said.
But in May of this year, Dr. Tam sounded a different note. Anticipating the WHO’s downgrading of the global risk of COVID-19, she told reporters: “We mustn’t, I think, let go of the gains that we’ve had in the last several years … I think whatever the decision is made by the director-general of WHO, I think we just need to keep going with what we’re doing now.”
The lack of a clear prevention and response plan for future pandemics is especially concerning when we compare the tone of Canadian officials today with the alacrity shown by federal and provincial governments two decades ago during an outbreak of severe acute respiratory syndrome (SARS). In early May, 2003, Canada’s then-federal health minister, Anne McLellan, sought to illuminate the circumstances surrounding Canada’s response to SARS, which had begun spreading four months earlier in Toronto.
The mandate of the National Advisory Committee on SARS and Public Health, Ms. McLellan said at the time, was to provide “a third-party assessment of current public-health efforts and lessons learned for ongoing and future infectious disease control.” Five months later, in October, 2003, the committee presented its findings and recommended creating the Public Health Agency of Canada (PHAC), whose first chief public health officer was appointed in September, 2004.
Less than two years elapsed between the start of the SARS epidemic and the creation of the newly funded infrastructure designed to address zoonotic threats and other public-health imperatives. Within several years, the federal government, along with those of British Columbia and Ontario, had modernized their public-health legislation to incorporate lessons from SARS.
The PHAC says that they are now bolstering their pandemic preparedness efforts. However, there is a dearth of detail on how these efforts will specifically respond to concerns raised in a report published by the Auditor-General of Canada in 2021, assessing PHAC’s COVID-19 response. The report stated that the “Public Health Agency of Canada was not adequately prepared to respond to a pandemic, and it did not address long-standing health surveillance information issues prior to the pandemic.”
PHAC had originally said it planned to release more information to this effect by December, 2022, but that response is now months overdue. This leaves policy experts piecing together potential narratives by hunting and pecking for morsels of information, combing through government websites and interpreting guarded responses from officials.
The appropriate time for an inquiry has passed.
Instead, it’s now the appropriate time for officials to make public their plans for how the government will avoid being caught flat-footed when confronting the next pandemic.