Canadian doctor once posted to Beijing ignored by Ottawa after offering help with COVID-19 response

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For seven years, Felix Li served on the distant front lines of Canadian public health, in China. As a doctor posted to Beijing, he fostered ties with health authorities that let him peer beneath the official rhetoric of a country that has been the source of multiple viral epidemics in recent decades.

When Dr. Li returned to Canada in 2015 and retired from the Public Health Agency of Canada (PHAC) after 23 years, he was not replaced.

But he retained his contacts inside the Chinese public health system and was keen to help when another outbreak began to emerge.

So, a few days after the Jan. 23 lockdown of Wuhan, he sent an e-mail to the PHAC, including Chief Public Health Officer Theresa Tam, offering his expertise.

“I offered to go back to Ottawa to work with them on this. I needed to help, to save lives,” Dr. Li said in an interview.

In the e-mail, he described his knowledge of the Chinese system and the contacts he maintains there.

“I got an e-mail back saying, ‘We’ll talk about it and let you know.’ But I never had any response after that.”

Instead, the PHAC has relied heavily on the World Health Organization for information and guidance in its response to the rapid spread of the deadly new virus.

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But critics have questioned the relationship between the WHO and China, whose response the WHO has praised effusively. The health organization has raised few public concerns about the reliability of information provided by Beijing, despite evidence suggesting Chinese authorities have significantly underreported the death toll from the outbreak.

Dr. Li said that, during his time in China, there was a difference in “the quality of the information” he was able to obtain by communicating directly with people at China’s Ministry of Health and the Chinese Centre for Disease Control and Prevention. During the 2013 H7N9 avian influenza outbreak, for example, he received updates directly from Chinese officials.

Were he working now, he’d “probably get a lot more timely and accurate information on things,” he said.

There is good reason to seek more sources of information, public health experts say.

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“In any acute emergency, there is always benefit of ‘on the ground’ expertise and contacts in getting access to data and understanding the nuances of actual context. There is also always value in having multiple sources of data, information or intelligence, and it would be wise to have as many sources as possible,” said James Orbinski, director of York University’s Dahdaleh Institute for Global Health Research.

“Relying on one source of information for critical decision making leaves you open to all of its biases and limitations, and every source – even ‘official’ ones, like the WHO, the government of China, the CIA, the government of the United States, the government of Canada – has biases and limitations.”

The PHAC says it has full confidence in its methods – and in the WHO. “With the situation related to COVID-19 continuing to evolve rapidly around the world, Canada will continue to work closely with its international partners, including the WHO and China, as well as with provincial and territorial counterparts to reduce risks to Canadians and the global community,” spokesperson Anna Maddison said in an e-mailed statement.

The agency can rely on Canada’s foreign service “to share and gather information related to health and public health matters,” Ms. Maddison said.

Canada’s embassies and consulates in China, however, have been working with low staffing levels after non-essential staff – including provincial representatives – were sent home.

Unlike the U.S., Canada does not have a wide-reaching global public health service, which makes it reliant upon the WHO. That’s not a bad thing, said Srinivas Murthy, an infectious disease specialist at the University of British Columbia who has worked with the WHO.

“The WHO is a very reputable, very strong organization which has that capacity,” Dr. Murthy said. “I don’t think Canada specifically needs a foreign public health agency.”

But there are also risks in relying on an agency that itself relies on information from China, a country where statistics are often bent to political imperatives. The U.S. Centers for Disease Control and Prevention has itself been criticized for cutting its staff in China by two-thirds before the COVID-19 outbreak.

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In Canada, meanwhile, it appears health leaders are not receiving sufficient advice on the potential weaknesses of Chinese data being transmitted by the WHO, said Charles Burton, a senior fellow at the Macdonald-Laurier Institute who has twice worked out of the Canadian embassy in Beijing.

The result is that China’s “politically motivated misinformation tragically leads to unnecessary Canadian deaths,” he said.

Dr. Li began his public health work in Beijing in 2008 with the belief that “Canada should not be responding to epidemics or pandemics when they reach the shores of Canada. We should be proactively working with China.”

He declined to offer his views on how China and Canada have responded to COVID-19, for fear of damaging his relationships with public health officials he still hopes to work alongside.

“As a medical doctor and a public health doctor, our task is to save lives. If I were called upon, I’d jump on the next plane to Ottawa,” he said.

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