‘Without early warning you can’t have early response’: How Canada’s world-class pandemic alert system failed

This has to be considered a significant fail: disbanding the PHAC Global Public Health Intelligence Network, or GPHIN a few years before COVID-19.

Kudos to the Globe for good investigative reporting and analysis.

Given that resource reductions and reallocations are normally executed at the bureaucratic level (with political sign-off), one would hope that PHAC is revisiting this decision and the relative importance within PHAC of senior bureaucratic decision-makers vs scientific advice and expertise. Savoie’s comments on senior public servants as courtiers comes to mind when reading about these differences so well captured in the Globe report.

Some form of enquiry (preferably external) is needed  to assess how this short-sighted decision took place and the related accountabilities.

While there is no excuse for the ethical violations of the PM and Finance Minister regarding WE, it would be a far better use of Parliament to investigate this decision and its impact, given that it contributed to Canada’s missing the opportunity for an early and thus likely more effective response, with fewer deaths of Canadians:

On the morning of Dec. 31, as word of a troubling new outbreak in China began to reverberate around the world, in news reports and on social media, a group of analysts inside the federal government and their bosses were caught completely off guard.

The virus had been festering in China for weeks, possibly months, but the Public Health Agency of Canada appeared to know nothing about it – which was unusual because the government had a team of highly specialized doctors and epidemiologists whose job was to scour the world for advance warning of major health threats. And their track record was impressive.

Some of the earliest signs of past international outbreaks, including H1N1, MERS and Ebola, were detected by this Canadian early warning system, which helped countries around the world prepare.

Known as the Global Public Health Intelligence Network, or GPHIN, the unit was among Canada’s contributions to the World Health Organization, and it operated as a kind of medical Amber Alert system. Its job was to gather intelligence and spot pandemics early, before they began, giving the government and other countries a head start to respond and – hopefully – prevent a catastrophe. And the results often spoke for themselves.

Russia once accused Canada of spying, after GPHIN analysts determined that a rash of strange illnesses in Chechnya were the result of a chemical release the Kremlin tried to keep quiet. Impressed by GPHIN’s data-mining capabilities, Google offered to buy it from the federal government in 2008. And two years ago, the WHO praised the operation as “the foundation” of a global pandemic early warning system.

So, when it came to the outbreak in Wuhan, the Canadian government had a team of experts capable of spotting the hidden signs of a problem, even at its most nascent stages.

But last year, a key part of that function was effectively switched off.

In May, 2019, less than seven months before COVID-19 would begin wreaking havoc on the world, Canada’s pandemic alert system effectively went dark.

Amid shifting priorities inside Public Health, GPHIN’s analysts were assigned other tasks within the department, which pulled them away from their international surveillance duties.

With no pandemic scares in recent memory, the government felt GPHIN was too internationally focused, and therefore not a good use of funding. The doctors and epidemiologists were told to focus on domestic matters that were deemed a higher priority.

The analysts’ capacity to issue alerts about international health threats was halted. All such warnings now required approval from senior government officials. Soon, with no green light to sound an alarm, those alerts stopped altogether.

So, on May 24 last year, after issuing an international warning of an unexplained outbreak in Uganda that left two people dead, the system went silent.

And in the months leading up to the emergence of COVID-19, as one of the biggest pandemics in a century lurked, Canada’s early warning system was no longer watching closely.

When the novel coronavirus finally emerged on the international radar, amid evidence the Chinese government had been withholding information about the severity of the outbreak, Canada was conspicuously unaware and ultimately ill-prepared.

But according to current and former staff, it was just one of several problems brewing inside Public Health when the virus struck. Experienced scientists say their voices were no longer being heard within the bureaucracy as department priorities changed, while critical information gathered in the first few weeks of the outbreak never made it up the chain of command in Ottawa.

‘WE NEED EARLY DETECTION’

The Globe and Mail obtained 10 years of internal GPHIN records showing how abruptly Canada’s pandemic alert system went silent last spring.

Between 2009 and 2019, the team of roughly 12 doctors and epidemiologists, fluent in multiple languages, were a prolific operation. During that span, GPHIN issued 1,587 international alerts about potential outbreak threats around the world, from South America to Siberia.

Those alerts were sent to top officials in the Canadian government and throughout the international medical community, including the WHO. Countries across Europe, Latin America, Asia and Africa also relied on the system.

On average, GPHIN issued more than a dozen international alerts a month, according to the records. But its purpose wasn’t to cry wolf. Only special situations that required monitoring, closer inspection or frank discussions with a foreign government were flagged.

GPHIN’s role was reconnaissance – detect an outbreak early so that the government could prepare. Could the virus be contained before it got to Canada? Should hospitals brace for a crisis? Was there enough personal protective equipment on hand? Should surveillance at airports be increased, flights stopped, or borders closed?

This need for early detection sprang from a climate of distrust in the 1990s, when it was believed some countries were increasingly reluctant to disclose major health problems, fearing economic or reputational damage. This left everyone at a disadvantage.

For Canada, the wake-up call came in 1994 when a sudden outbreak of pneumonic plague in Surat, India, sparked panic. Official information was sparse, but rumours promulgated faster. As citizens fled the city of millions, many on foot, others boarded planes.

Public Health officials in Ottawa were soon alerted to an urgent problem: Staff at Toronto’s Pearson International Airport, fearing exposure to the plague, threatened to walk off the job if a plane arriving from India was allowed to land. The government scrambled to put quarantine measures in place.

“We were caught flat-footed,” said Ronald St. John, who headed up the federal Centre for Emergency Preparedness at the time. The panic demonstrated the need for advance warning and better planning.

“We said, we’ve got to have early alerts. So how do we get early alerts?”

Waiting for official word from governments was often slow – and unreliable. Dr. St. John and his team of epidemiologists didn’t want to wait. They began building computer systems that could scan the internet – still in its infancy back then – at lightning speed, aggregating local news, health data, discussion boards, independent blogs and whatever else they could find. They looked for anything unusual, which would then be investigated by trained doctors who were experts in spotting diseases.

It was a mix of science and detective work. A report of dead birds in one country, or a sudden outbreak of flu symptoms at the wrong time of year in another, could be clues to something worse – what the analysts call indirect signals.

Find those signals early enough, and you can contain the outbreak before it becomes a global pandemic.

“We wanted to detect an event, we didn’t want a full epidemiological analysis,” Dr. St. John said. “We just wanted to know if there was an outbreak.” …

Source for remainder: https://www.theglobeandmail.com/canada/article-without-early-warning-you-cant-have-early-response-how-canadas/

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

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