Government | Multicultural Meanderings

Public servants say they work better from home, despite stress: survey

2021/05/20 Leave a comment

Interesting (on my to do list, look at the survey’s disaggregated data):

During the pandemic, employees of local, provincial, and federal governments from coast to coast to coast have provided essential services while working from home.

And it would appear that federal employees are happier now about their workplace than they were before the pandemic, according to the 2020 Public Service Employee Survey released by the Treasury Board Secretariat last week.

While we don’t know the full story of the “big pivot” over a single weekend in March 2020 — when public servants started working from home — we do know many have been working over weekends and statutory holidays and forgoing annual leave.

This isn’t sustainable over the long term. If not attended to, such behaviour could result in a crash or organizational failure.

Stress has increased since 2019. A third of employees said they felt emotionally drained after their workday, up from 29 per cent in 2019. Just over a quarter said their workload was heavier, up slightly from 24 per cent in 2019.

However, new questions in the 2020 survey about work-life balance during the pandemic revealed some silver linings:

39 per cent of employees had requested flexible work hours since the start of the pandemic; and

83 per cent said their immediate supervisor allowed them.

Employees said the quality of their work improved, too. For example:

only 23 per cent of employees said their work quality suffered because their department or agency lacked stability, which was down from 30 per cent in 2019; and

just 24 per cent of employees said their work suffered because of high staff turnover, down from 32 per cent in 2019.

Employees’ perceptions of change management also improved in 2020, with 59 per cent saying change was managed well in their department or agency, compared to 50 per cent in 2019.

They also reported better feedback from their supervisors in 2020, compared to 2019:

69 per cent said they received meaningful recognition for work well done, up from 65 per cent in 2019; and

77 per cent said they got useful feedback from their immediate supervisor about their job performance, up from 74 per cent in 2019.

Overall job satisfaction improved in 2020, too:

83 per cent of employees said they liked their job, up from 81 per cent in 2019;

78 per cent reported getting a sense of satisfaction from their work, up from 76 per cent in 2019;

75 per cent said they were satisfied with their department or agency, up from 71 per cent in 2019;

75 per cent said they would recommend their department or agency as a great place to work, up from 70 per cent in 2019; and

71 per cent of employees said they felt valued at work, up from 68 per cent in 2019.

Respondents also felt their workplace was “psychologically” healthier. For example:

68 per cent said their workplace was psychologically healthy, up from 61 per cent in 2019; and

81 per cent said their department or agency was doing a good job of raising awareness of mental health in the workplace, up from 73 per cent in 2019.

In response to a new question in 2020, 69 per cent of employees said they’d feel comfortable sharing concerns about their mental health with their immediate supervisor.

The survey included new questions about working during the pandemic:

70 per cent said senior managers were taking adequate steps to support their mental health during the pandemic;

84 per cent felt their department or agency was effectively communicating the mental-health services and resources available to them; and

81 per cent said they were satisfied with the measures their department or agency was taking to protect their physical health and safety during the pandemic.

Employees were also asked about the information they received from their department or agency about the pandemic:

78 per cent said it was clear and easy to understand;

81 per cent said it was consistent with the information they got from their immediate supervisor; and

92 per cent said the information was available in both official languages.

And finally, instances of harassment also fell. In 2020, 11 per cent of employees said they’d been harassed on the job in the previous 12 months, down from 14 per cent in 2019. In addition, 71 per cent said their department or agency worked hard to create a workplace that prevents harassment, up from 69 per cent in 2019.

So while the pandemic isn’t over, public servants remain engaged. It would appear that working from home and away from the office has improved their view of the workplace and of their senior managers.

Stephen Van Dine is the senior vice-president of public governance at the Institute on Governance.

Source: Public servants say they work better from home, despite stress: survey

Filed under Government Tagged with PSES, remote work, TBS

Sunshine lists have helped narrow the gender pay gap, but Ottawa won’t commit to one

2021/05/18 Leave a comment

While I understand the attractiveness of sunshine lists, I find this places too much emphasis on the individuals rather than systemic trends and gaps.

There is a wealth of government employment equity data for the four groups – women, visible minorities, Indigenous peoples and PwD – that can be disaggregated by occupational level. For example, an earlier analysis I did with TBS data:

While situations are different in universities, crown corporations and the like, where individual salary differences can be greater, in the federal public service it is the group and level that determine salaries, not individual negotiations. It would however, be useful for someone to request anonymized EX performance pay data to see if any significant gender and other differences:

The federal government does not release an annual “sunshine list” – a document outlining the name, compensation and often job title of its high-earning employees – unlike almost every province. And the Trudeau government has no plans to change this practice.
The Globe and Mail asked Treasury Board President Jean-Yves Duclos if the Liberals, who ran on a platform of government transparency and gender equity in 2015, would consider passing legislation on public-sector salary disclosure. Spokesman Martin Potvin replied that the board is “not currently working on any changes to how it reports” employee compensation.
This is despite years of feedback from equity advocates and researchers, who say sunshine laws have helped narrow the gender wage gap, as well as pressure from stakeholder groups concerned about a lack of transparency.
Beyond the issue of taxpayer accountability, sunshine laws around the country have revealed inequities in hiring practices, promotion and compensation.
For example, Anita Kozyrskyj, a professor in the department of pediatrics at the University of Alberta, was part of a group of female professors who used the university’s disclosure list to expose pay inequities within the faculty of medicine and dentistry. The academics found a $5,000 gender wage gap after accounting for factors such as rank and years of experience.
“[It] would not have been possible had we not had the sunshine list,” said Prof. Kozyrskyj, who learned she personally was making about $20,000 less than her equivalent male peers. (A similar report by academics at the University of Alberta used the sunshine list to reveal pay and representation gaps between men and women professors, as well as white and racialized faculty.)
Other research, such as a study from economists at the University of Toronto that examined the impact of sunshine laws on gender pay imbalances in academia, suggests disclosure leads to reduced inequities.
“The gender pay gap, in general, has been shrinking over time, and these laws have accounted for about 30 to 40 per cent of the closure since these laws were passed,” said one of the authors, Yosh Halberstam.
Universities that were unionized showed the clearest improvement, he added, suggesting progress requires both a mechanism to expose inequities, as well as a framework for staff to advocate for themselves.
Since January, The Globe has been publishing a series called the Power Gap, which looks at gender imbalances in the modern work force. By collecting sunshine lists from hundreds of employers across the country, the project produced an unprecedented look at where women stand within vital public institutions.
The data revealed how women’s careers are stalling out in mid-level management and how, on average, women made less than comparable male colleagues. But The Globe could not analyze federal employees, includingthose who work for the RCMP, public health, the Canada Revenue Agency or for federal Crown corporations – such as the Bank of Canada or Via Rail Canada – because the information is not available.
The Canadian Taxpayers Federation has been calling for Ottawa to introduce sunshine legislation for many years. “I think it’s a very simple transparency argument. There’s no reason that – if [almost] all the provinces are doing it, the federal government shouldn’t follow suit,” said Aaron Wudrick, the federal director of the organization.
The federation’s interest in the issue is centred around taxpayer accountability, which was then-premier Mike Harris’s motivation when his Progressive Conservative government passed Ontario’s sunshine law in 1996.
Other provinces followed suit over the past quarter century. Sunshine laws require government-owned or funded entities – such as schools and universities, Crown corporations, hospitals, the core public service and usually municipalities – to release data for all employees who earn more than a certain threshold, usually six figures. Today, every Canadian jurisdiction except Prince Edward Island, New Brunswick, the territories and the federal government requires some form of disclosure for top earners. (In Quebec, only senior managers are subject to compensation disclosure.)
These lists are not without controversy. Politically, they have been used to shame well-compensated civil servants. But in daily practice, they are a vital tool of information for women and other equity-seeking groups.
Lorna Turnbull, a feminist legal scholar and law professor at the University of Manitoba, has spent decades studying and writing about the legislative attempts from government to narrow the economic inequality between men and women. A common thread in her research has been that laws alone are not enough to protect against discrimination. For example, it’s been illegal for decades to pay equally qualified men and women different salaries for the same job because of their gender, but it still happens.
In 2011, she encountered her own real-life example. Prof. Turnbull competed for – and won – the position of dean in the faculty of law. She was to be the first woman to hold that position in the school’s nearly 100-year history. But when discussions turned to salary, Prof. Turnbull realized she was being offered less than her male predecessors.
“I was able to discover this because Manitoba has a sunshine list,” she said. Prof. Turnbull used intel from the disclosure list to negotiate a higher salary. She served as the university’s dean of law until 2016.
Prof. Turnbull said modern-day discrimination is very rarely the kind of overt, easy-to-spot bias that was typical decades ago when governments began passing anti-discrimination laws. Without access to the hard numbers, women and other marginalized groups might never know they’re not being properly paid.
Sarah Kaplan, director of the Institute for Gender and the Economy at the University of Toronto’s Rotman School of Management, said sunshine lists are not without drawbacks, but on the whole they are useful.
“The downside is that if you are on the sunshine list and you can see that others of your peers are paid more than you, it can be very demotivating. Often, there is little possibility to negotiate pay adjustments once you are in the job,” she said. “But over all, the transparency can increase pressure for long-term change, such as promoting more women to the higher-paying roles and paying women more fairly when they are hired.”
The most recent province to pass sunshine legislation is Newfoundland and Labrador, after efforts from former St. John’s Telegram reporter James McLeod.
In 2015, the Progressive Conservative government promised to introduce salary-disclosure legislation, but after it lost power, the Liberals were indecisive about doing the same, Mr. McLeod says.
“I thought, if the government won’t do a sunshine list, I’ll do it myself.”
Mr. McLeod filed freedom of information requests with large public agencies and the issue ultimately ended up in court. With public pressure building, the government passed sunshine legislation on its own in 2016. (Also, Mr. McLeod’s case won on appeal.)
Gordon Scott Campbell, an information and privacy lawyer at Aubry Campbell MacLean, said one advantage that Mr. McLeod’s case had is Newfoundland’s freedom of information legislation actually states the public is entitled to know a civil servant’s salary. The federal act, on the other hand, states the public is only entitled to a salary range. As a result, it would almost certainly require a legislative change to release specific salary amounts.
Mr. Campbell said there is always tension between access and privacy.
“Privacy legislation seeks to strongly protect Canadian privacy … access-to-information legislation seeks to broadly free government information,” he said. “I think most Canadians would support [both]. So it’s a balance.”

Source: https://www.theglobeandmail.com/canada/article-sunshine-lists-have-helped-narrow-the-gender-pay-gap-but-ottawa-wont/?utm_medium=email&utm_source=Morning%20Update&utm_content=2021-5-17_5&utm_term=Morning%20Update:%20Israel%20vows%20to%20continue%20attacks%20as%20ceasefire%20negotiations%20falter&utm_campaign=newsletter&cu_id=%2BTx9qGuxCF9REU6kNldjGJtpVUGIVB3Y

Filed under Government Tagged with employment equity, salary differences, Sunshine List

National security threats are changing, but Canada is mired in conventional thinking

2021/05/01 Leave a comment

Valid arguments:

An invisible virus borne on the air and reaching across continents and oceans, moving freely among people, disrespecting borders and ideas of state sovereignty, will mark the most profound shake-up of thinking about national security since the beginning of the atomic age in 1945.

We have entered an era in which national security is not just about protecting the state against adversaries, but also against dangers that have a direct impact on the daily lives of people.

The vectors of these threats are new and different — they don’t present the menacing face of armies and war, the shadowy artifice of the traditional spy, or the low-tech threat of terrorism. The new threats come at us straight out of our digital environment and are unleashed out of the natural world.

Digitally enabled threats take aim at precious resources — our data, our economy, our research — and the fundamentals of our democracy. They rob us and bend the truth, and as more of our economy is digitally enabled it is capable of being digitally disabled.

Natural hazards from climate change and the globalized spread of serious infectious diseases threaten livelihoods and lives across the country.

Thinking about national security in Canada has long been the preserve of small cadres of federal government officials and even smaller elements of civil society, each profoundly disconnected from the other. It’s not a subject taught much at our colleges and universities, from which future generations of leaders emerge as innocents. National security has rarely penetrated public debate, hardly ever featured in election campaigns, and only spasmodically seized the headlines — usually in moments of scandal.

In the new environment in which we live, that must change.

Government, political parties, and civil society must all pivot to a new understanding of what national security means and how threats are expected to be met.

We have, in Canada, a long way to go to embrace this new and disquieting understanding of national security, yet our collective future depends on it.

The distance we have to go was on display recently in two reports tabled in Parliament.

One was presented by the National Security and Intelligence Committee of Parliamentarians (NSICOP), a cornerstone of the Liberal government’s efforts to create a much stronger system of review for our security agencies. NSICOP devoted the entirety of its 2020 annual report to an analysis of the national security threats facing Canada.

This was a laudable endeavour, but one mired in conventional thinking. It failed to be sufficiently forward looking, and the committee limited itself to a discussion of five threats:

Terrorism

Espionage and foreign interference

Malicious cyber activities

Major organized crime

Weapons of mass destruction

All of these are undoubtedly threats, but look hard at this list and you see the conceptual problems.

To give priority of place to terrorism threats is legacy thinking. Espionage and foreign interference are distinct problems, not to be mashed together. Organized crime comes into the national security picture only in very specific manifestations.

More problematic by far is what is missing: pandemic and biosecurity threats, climate change security impacts, and economic security. Precisely the issues that matter most to Canadians, the ones that have the greatest impact on their daily lives, were absent from the frame.

The Canadian Security Intelligence Service (CSIS), in its annual public report for 2020, did better. It is clear from the report that CSIS is seized by threats to Canada’s economic security, including those that emerged to the bio-pharma sector during the early months of COVID-19.

Likewise, troubling state-sponsored disinformation campaigns are now on the CSIS radar. Counterintelligence, long a pillar of CSIS operations, is now focused beyond espionage on foreign interference operations.

The CSIS mandate places it squarely in the fight against violent extremism, but unlike the National Security and Intelligence Committee of Parliamentarians, CSIS does not make this the top item in its picture of the threat environment.

And CSIS is working alongside the Communications Security Establishment in trying to understand and counter cyber threats.

However, the CSIS picture of the threat environment is necessarily geared to its lawful mandate. It doesn’t have a pandemic security mission writ large, or a climate change security mandate.

To embrace those missions properly will require new thinking and new ways of organizing our national security apparatus.

When it comes to national security, the past is not prologue. The present is moving fast and the future is hard to get a grip on. But here is a prediction: the comfortable and time-honoured habit of treating national security as far-removed from the general public discourse, of erasing it from politics, is over.

The 2015 federal election in which the Conservatives stumbled over opposition to their anti-terrorism legislation was but a small foreshadowing of a much larger debate over how to live safely, prosperously and democratically in a new age.

The next federal election campaign will be one in which all parties will have to prepare coherent and plausible visions of national security, and argue them in public in the interests of all Canadians.

Source: National security threats are changing, but Canada is mired in conventional thinking

Filed under Government, Security Tagged with national security, Wesley Wark

How one federal agency broke free of outdated IT infrastructure

2021/04/30 Leave a comment

While written a bit too much as a puff piece, an interesting and relevant example of modernization (some of these remind me of my time in the early days of Service Canada and IT infrastructure renewal, where of course the issues were on a much larger scale and higher risk for CPP and EI):

The COVID-19 pandemic has laid bare the need for modern, agile IT systems as both the public and private sectors grapple with a suddenly remote workforce. Cloud platforms are the backbone of modern IT infrastructure, providing scalability, speed, and remote access, and are secure without the expense of physical infrastructure. Yet less than 10 per cent of federal departments have transferred some of their operations to a cloud platform. Part of this is because the pandemic diverted focus, but it is also due to fear of the unknown and uncertainty over security benefits and procurement rules.

Had the pandemic struck five years earlier, Canada Mortgage and Housing Corporation (CMHC) would have been crippled by its lagging IT infrastructure. Instead, CMHC’s operations continued without missing a step – even supporting the government’s pandemic response by rolling out critical economic support with record speed, such as the Canada Emergency Commercial Rent Assistance for small businesses and the Insured Mortgage Purchase Program to support the financial system.

CMHC’s partnership approach to transforming its IT infrastructure can serve as a model for other federal departments. CMHC and Accenture, a global professional services company, came together five years ago to move CMHC’s outdated and siloed systems to a robust digital service platform.

Back in 2016, CMHC relied on close to 1,000 separate software applications, many of which were customized and hard to maintain. From operations and insurance underwriting to applications for program funding and accounting, every structure had its own siloed system.

Technology was a source of frustration. Twenty-three per cent of CMHC employees rated it their number one barrier, and one in six employees spent their time trying to find data.

Today, those systems have been replaced with enterprise platforms that have automated manual tasks, sped up processing times and offer real-time data to support better decision-making. This endeavour was no small feat. Finding the right partner and doing a thorough analysis of the scope of the challenge took over a year.

Together as CMHC’s deputy chief information officer and Accenture’s federal government practice lead, we helped execute a project that took place over several years and involved hundreds of employees from both organizations. Ultimately, we found that how we implemented the technology was just as important as the technologies we invested in. Sometimes it was even more important.

Here are five key lessons learned that we believe can help other departments successfully approach digital innovation:

1. Leadership buy-in is crucial

The journey for the project – called CMHC in Motion – began under CMHC’s president and leadership team with the goal of becoming a more agile, focused and efficient company with a culture of accountability.

CMHC modernized its organizational structure and focused on communication and training to manage risk, change and execution and to encourage innovation. Fixing technology was the next step.

The leadership team ensured the building blocks were in place for technology and business transformation. Program funding and resources were made available to drive this three-year transformation and its evolution for years to come.

The CIO role was elevated. Now the CIO sits on CMHC’s executive committee and is positioned to influence decisions that affect all parts of the company. Digital and technological thinking need to be able to influence business strategy rather than being made to fit into strategy that is already set. The two need to evolve hand-in-hand.

2. Innovative solutions require innovative approaches

It was clear from the start that the traditional procurement route of a complicated and time-consuming request-for-proposal process would be an obstacle for the project. Inviting potential partners to analyze the scale of the problem was critical to finding not only the right partner but also the right solutions. For three months, two potential partners were given access to CMHC’s infrastructure and systems to fully assess the scale of the situation they would face. More importantly, it allowed CMHC to leverage the experience of external experts in defining the solution. Incorporating this into the proposal process allowed for a broader, more robust and feasible path forward.

When CMHC and Accenture came together there was already an understanding of the challenges and potential solutions, and the project team was able to move straight to planning implementation.

3. A true partnership and governance structure is vital

From day one, CMHC wanted a partner. The vision was an arrangement where both parties shared in the benefits and risks and would collaborate on challenges. Given the complexity and timelines of the project, it was impossible to predict where the work would lead, what outcomes and technologies would be needed or even be available. A risk-sharing fund positioned both parties to carefully consider potential project variances and cost overruns, and both parties came together to solve emerging needs and to consider any potential changes to the scope of work.

Agreeing up front to share in the financial risk is not the norm for public sector transformation projects, but it eliminated years of delay as we avoided time-consuming project scoping, trying to describe the perfect solution. It meant that CMHC was not dictating a solution, but rather defining the problem and getting fresh outside perspectives on how to address it through a cohesive joint team.

Managing outsourcing relationships isn’t easy, so CMHC created a partner relationship management team. Three levels of governance are used at CMHC. It starts at the highest level, with the executive team, then flows to the management and operational governance structures. On a bi-weekly basis CMHC and Accenture Canada’s CEOs met to discuss program performance, relationship status and planning. Five years after the contract was signed, these meetings still take place.

4. Commit to an uncharted path

A multi-year transformation will not follow a straight path. Innovative, agile organizations need to be open to imperfection and experimentation. Innovation requires an acceptance that not all ideas work, and that getting out of planning mode and into testing mode happens so we can learn, adapt and move forward. Progress over perfection and timeliness was important, and we made risk-based decisions to move quickly.

For CMHC, technology was also used to help drive a change in culture around risk-taking, speed and being ok with failure. For CMHC and Accenture, there was an understanding that immediate answers would not always be available, especially with rapid advances in technology. This enabled the delivery team to take risks and push forward at a quicker pace, knowing that it was ok to fail fast to avoid the lengthy detours of searching for the “perfect” solution.

Along the journey, unforeseen events – like the introduction of the National Housing Strategy in 2017 and the COVID-19 pandemic – required significant changes to plans and priorities. CMHC was able to adapt, demonstrating that with the right culture and committed senior leadership, organizations can become resilient and better equipped to respond to unexpected changes in their business environment.

5. Create a feedback loop to guide the pace of change

Engaged and enabled employees can make or break transformative IT projects. Change management is often the first thing to cut when an organization is trying to save its resources, yet it is one of the areas we found to be critical. Continuous dialogue and check-ins through surveys and consultations ensured employees believed in the transformation and had the skills and confidence to adopt transformed business approaches. It is essential to communicate early and often to employees in a transparent and simple way.

To get early buy-in from employees and to show our commitment to making this transformation work, the first project we tackled was the one with the biggest positive impact for our employees – moving off Lotus Notes email to Outlook and Skype. The success of this implementation was instrumental in gaining buy-in from employees and made the transformation real for them.

We were cognizant of the massive cultural shift we were asking employees to make. Their entire technological world was being altered, from a new email platform and filing systems, to a client relationship management system, invoicing and how they manage client requests. We developed a “heat map” to identify which areas of CMHC were undergoing the most change. With the map and employee feedback, we were able to adjust our approach and ease up where the pace of change was too intense. We worked alongside senior management and human resources to continuously evaluate progress and identify areas that needed more training or support.

Moving forward

We find ourselves at an exciting time, where rapid innovation in technology has the potential to drastically change the way we develop and deliver public programs and policy. Over the past few years, technology companies have improved the ease of use, security, scale and interoperability of their offerings. The flexibility and cost-effectiveness of cloud services are undeniable.

The pandemic has highlighted the need for agility in our IT infrastructure. As Canadians look to all levels of government to lead them through these unprecedented times, they have seen the tangible results of government in action to keep them safe, provide them with financial support and navigate the road to economic recovery. Now is the time to build a better, more resilient IT environment for our public sector, one that will allow us to weather storms and continue to provide Canadians with world-class government services.

Source: How one federal agency broke free of outdated IT infrastructure

Filed under Government Tagged with CMHC, modernization

For Vaccine Passports, Less Tech Is Best

2021/04/22 Leave a comment

Of interest given that discussion has already started in the Canadian context:

I have been reluctant to write about whether and how Americans might provide proof of vaccination against the coronavirus. It’s a political, cultural, ethical and legal minefield. Technology is not the point at all.
But if some workplaces, schools, public gathering spots and travel companies start requiring a “vaccine passport,” it makes sense for them to do so in ways that preserve people’s privacy, are simple to use, win people’s trust and don’t cost a fortune.
Let me tell you about an intriguing proposal from PathCheck Foundation, a health technology nonprofit. The central premise is that technology related to our health should be as minimal as possible. That philosophy should be our North Star.
Here is one problem with some early technology approaches to digital vaccine credential systems: They create too many middlemen that tap into your health records, said Ramesh Raskar, an associate professor at the M.I.T. Media Lab who also founded PathCheck.
In the United States, states are mostly the ones maintaining records of which residents are vaccinated. Early efforts to create vaccine credentials, like the Excelsior Pass in New York, essentially create a replica of those state databases with information including your name, date of birth, address, the batch numbers of your shots and so on. And that’s what businesses and others access when they check whether people walking in the door are vaccinated, Dr. Raskar said.
When you add multiple layers of technology into any system, it increases the possibility of your sensitive data leaking out. It’s also expensive and complicated for everyone involved. “It’s completely unnecessary,” Dr. Raskar told me.YOUR CORONAVIRUS TRACKER: We’ll send you the latest data for places you care about each day.Sign Up
PathCheck’s idea is to create simple software code that anyone — workplaces, schools or airlines — can incorporate into apps, without the need to replicate health records.
When you need to show a vaccination credential, a one-time code would transmit two pieces of information: your identity, and that you’re vaccinated. Yes, there’s still a middleman, but the difference is that the apps would do as little as possible to access your sensitive information. The relevant data is communicated more directly between your phone and the state health records. You might have to show your ID, too.
He compared this proposal to paying for a sandwich with cash instead of a credit card. There is no need for a complicated paper trail to buy lunch. The metaphor isn’t perfect, but it’s useful.
Some of the organizations pitching vaccination credential technology, including IBM and the airport screening company Clear, are making a similar pitch that their technologies are as minimal as possible.
Dr. Raskar says that they’re often not, because tech companies, states and others have tried to throw a lot of smarts at the problem. If you hear the word “blockchain” with vaccine credentials, know that something has gone off the rails. The risk is that we get complicated, potentially incompatible technology for people to provide proof of vaccination.
What we really need is dumb technology that does as little as possible and knows as little about us as possible. “How can we make it simple, simple, simple as opposed to what technology companies are doing, which is to add more?” Dr. Raskar said.
PathCheck is just one of multiple companies and nonprofit groupsthat are developing fraud-proof vaccination credentials. It’s going to be confusing for awhile as these technologies are evaluated and tested.
But PathCheck deserves credit for turning the approach to vaccination credentials on its head. Less and dumber technology is usually the best.

Source: https://www.nytimes.com/2021/04/20/technology/covid-passports-vaccine-technology.html

Filed under Government Tagged with COVID-19, vaccine passports

Justin Ling: How Ontario’s health advisors handled the ‘darkest day’ of the pandemic

2021/04/21 2 Comments

Case study of speaking truth to power:

There are plenty of tough jobs in Ontario right now: From those moving parcels at Amazon warehouses to those guiding i-beams at a condo construction site, workers are facing the grim of reality of the pandemic.

Workers are going to the job site everyday without the guarantee of sick pay if they fall ill, need to get tested or snag a much-coveted vaccination spot.

There is one particular job that might not carry the same risks, but which still isn’t inspiring much envy these days: Being a member of the Ontario COVID-19 Science Table.

The Table, composed of some 100 doctors, researchers and specialists, is the independent body that furnishes advice to Premier Doug Ford and his cabinet on how best to beat back the deadly pandemic. It is their modelling that shows Ontario careening towards 30,000 news cases per day.

But it was their advice—to shut truly non-essential workplaces, pause construction where possible, and prioritize more vaccines for front-line workers—that was summarily ignored.

Instead, they dispatched officers to police a pandemic: As a pre-teen in Gravenhurst recently found out. They promised more inspectors, but that means very little if the provincial regulations allow employees to remove their masks on the job—a recent outbreak at a provincial testing laboratory shows that nowhere is truly safe from the virus.

The whole Table is in an impossibly awkward spot. Ford continues to tout their work, insisting it has informed his own approach to the pandemic. But, in practise, his actions have consistently been directly at odds with the advice from the Table.

Last week, as the divergence between advice and action grew wider, talk around the Table turned to mass resignation. A protest, in essence, of being used by a government that appears to have little interest in a science-based approach to fighting the pandemic.

But the majority of the Table opted, instead, for a softer approach: One that retains cautious optimism that the Ford government may yet see the light, and pursue measures that may actually avert a worst-case scenario in the province.

To underscore their position, the Science Table drafted a letter to the government with pointed advice on what to do next. It’s a letter that lays out the choice the Ford government faces. Whether or not he will make the right decision is, ultimately, up to him.

***

On Friday afternoon Dr. Adalsteinn Brown, the co-chair of the Science Table, appeared alongside Dr. David Williams, the province’s Chief Medical Officer of Health to present new modelling on the risks facing the province.

“Without stronger system-level measures and immediate support for essential workers and high-risk communities, high case rates will persist through the summer,” the presentation warned.

Brown said financial support for workers and strict measures for workplaces were desperately needed: “We need to stop infection coming into our central workplaces,” he said.

Vaccines, he added, were a central part of the strategy but wouldn’t solve this problem on their own.

The lines on the graph were three colours: Green, which rose slightly, then bent towards the X-axis. Yellow, which wobbled upwards so slightly—hovering right above 10,000 cases per day. And, finally, the red line: A line that sloped menacingly upwards, past the 30,000 marker.

Ontario is currently trending along the yellow line.

Red, yellow, and green dotted lines shadowed each of the solid lines: They represented what case counts would look like if Ontario managed to ramp up from the status quo, 100,000 vaccines administered per day, to an arbitrary number of 300,000 shots per day.

“Under every scenario, more vaccines mean a faster resolution in the long-run,” the presentation explained.

The Table communicated the crisis looming, and provided clear advice on how to avert disaster—both publicly and privately.

Hours later, after prolonged cabinet discussions, Ford appeared in front of television cameras to announce his decision: Playgrounds and outdoor sports would be banned. Outdoor gatherings forbidden, for members outside our household. Police would be dispatched to enforce the orders, with nearly-limitless authority to stop and question anyone in public. More inspectors would be dispatched to workplaces, but there would be no meaningful change to what constituted an ‘essential’ workplace. The number of vaccines reserved for frontline workers in hotspot zones would be set at 25 per cent.

The premier waved a sheet from Brown’s presentation: The chart showing the case projections. He seized on the idea that 300,000 vaccines could blunt this punishing third wave. “Would we be in this position if we were getting 300,000 doses a day back in February? Like the rest of the world? The answer is absolutely not,” Ford said.

The province looked on in alarm. The premier was, effectively, announcing a police state. Meanwhile, he was ranting at the federal government for not sending enough vaccines. When asked directly why he couldn’t shut more businesses, Ford explained how “deep” the supply chains were—light switches wouldn’t be made, he explained.

Reaction from the public was swift, and horrified. But the members of the Science Table, in particular, were beside themselves. Brown and fellow co-chair Brian Schwartz sent an email to dozens of his colleagues on the Science Table.

“We know that many of you are frustrated and angry after today’s announcements,” Brown and Schwartz wrote.

“We did the right thing,” they wrote of their early afternoon briefing, which set the stakes for Ford’s 4 pm announcement. The research and data, furnished by members of the table, they wrote: “Made it possible for us to be firm in saying what we know should be done to fight the pandemic.”

Several members of the Table took to Twitter to blast the decision. One member, Dr. Andrew Morris—who is a University of Toronto professor of medicine, a medical director in the Sinai Health System, and who co-chairs the Table’s working group on drugs and biologics—called the decision “criminal.”

Many of their blistering repudiations of the government’s decision were splashed on the frontpage of the Toronto Star on Saturday morning.

Brown and Schwartz didn’t discourage the comments. “The only thing we would ask is that you speak truth to power in the same way you would conduct any other discussion,” they wrote.

They summed up, in bullet points, the recommendations and analysis they had been providing for weeks: More vaccines for high-risk communities, close businesses that are not absolutely necessary, do more to protect workplaces that must remain open, create dedicated sick leave benefits, reduce mobility within the province, and encourage people to meet outside safely.

“Unfortunately, our advice does not align with what the cabinet announced this afternoon,” they wrote. “That requires serious discussion.”

Brown and Schwartz signed off the email, recognizing that many of the members were actually on the front-lines of this deadly fight. For those still on clinical duty, they wrote, “we wish you and your patients the very best through this exceptionally challenging weekend, and that you get a few moments of rest too.”

They arranged a 10 am Sunday morning meeting to discuss next steps.

In the outside world, pressure was mounting. Registered Nurses Association of Ontario CEO Doris Grinspun called for the Science Table to “resign en-masse.”

***

On Saturday afternoon, the Ford government appeared to walk back its enforcement measures, which would have given police nearly unfettered power to stop and interrogate people out for a walk, or driving, and ask their home address and purpose for being out in public.

The retreat came after nearly every police force in the province said they would refuse to conduct the arbitrary stops—journalist Andrew Lawton found that only the Ontario Provincial Police said they would enforce the measures.

Yet the supposedly walked-back regulations still allow police to stop anyone on the suspicion that “an individual may be participating in a gathering that is prohibited.” Of course, provincial regulations now ban any outdoor gathering, except for those in the same household. The new regulations allow police to demand the individual provide “information for the purpose of determining whether they are in compliance with that clause.”

Lawyers pointed out that the new, supposedly “refocused,” measures actually gave police more power to interrogate Ontarians on flimsy grounds. A group of young skateboarders in Gravenhurst would learn that reality pretty quickly on Sunday morning. Leanne Bonnekamp’s 12 year old son was out skateboarding with friends—in a park near the YMCA, as the skate parks were closed by provincial order. That’s when a cop approached.

“Two officers showed up, yelled at these kids—that they weren’t wearing masks, and weren’t socially distanced,” the boy’s mother, Bonnekamp, told me. One of the Ontario Provincial Police officers demanded the kids’ ID, and was running it in his cruiser as his partner stayed with the other youth.

Bonnekamp’s son was giving the officers attitude for the arbitrary stop—though no profanity, she says—as the cop gripped his scooter. In the video, the officer can be seen reaching over the scooter and shoving the pre-teen, who falls on the ground. When another youth asks just what in the hell the officers are doing, the cop yells “he’s failing to identify.”

The OPP says they are investigating the officer’s actions.

The same weekend, an outbreak in Toronto put into sharp focus the inadequacy of the government’s workplace measures. An outbreak of cases in a Toronto lab, run by Public Health Ontario to analyze COVID-19 tests, infected 16 employees.

The agency’s president Colleen Geiger sent an email to staff, which was forwarded to Maclean’s, indicating an investigation into the outbreak was ongoing and that they would identify “areas that require improvement.” Close contacts of those who tested positive, Geiger wrote, were already isolating. Other staff would be tested onsite.

One employee, who contacted Maclean’s with details of the outbreak but asked to remain anonymous because they were not authorized to speak to media, said the outbreak was just waiting to happen. Social distancing in the lab is nearly impossible and good public health measures aren’t being enforced, they wrote. Masks are often worn improperly and limits posted by the lunch tables and elevators aren’t respected.

This outbreak isn’t even the first. Previous instances where employees of the lab caught COVID-19 are “posted on bulletin boards that are tucked away in corners of hallways.”

The employee, quite correctly, argued that “Public Health of Ontario should hold a higher standard than the rest of Ontario residents and I find it shameful that this outbreak could have been avoided.”

Public Health Ontario confirmed to Maclean’s that 16 staff fell ill. “Diagnostic testing for COVID-19 as well as other infectious diseases are continuing as normal and there is no impact on laboratory services at this time,” they wrote.

If the provincial lab responsible for processing COVID-19 tests can’t even keep safe, how much trust can we put in other workplaces?

***

Sunday morning, Dr. David Fisman—professor of epidemiology at the Dalla Lana School of Public Health at the University of Toronto, and a member of the Science Table—wrote to the other members: “My concern is that the science and modeling tables are being used as cover.”

“What we saw on Friday was exactly the sort of thing I’ve been concerned about: Meaningful guidance from this group was disregarded,” he continued. “But the premier took the time to hold up a graph in which a hypothetical 300,000 vaccines per day scenario was plotted, and indicated that this would be the way forward.”

“As I have said at our meetings, at some point this starts to feel like aiding and abetting a government that has prosecuted a pandemic response that frankly feels negligent, or even criminal,” Fisman wrote.

“I don’t think I am on the same team as this government.”

That intense frustration was shared by many of his colleagues.

In an interview with Maclean’s, Morris said he was “dumbfounded” by the Friday announcement. At the same time, he called it an “apex” of a trend that has been growing over the course of the pandemic.

“When we get to Friday, they come out with these measures that are absolutely antithetical to the beliefs and advice of the Science Table — en masse, and individual members,” Morris says. “I don’t think there’s a single member who would have recommended those things.”

He phrases it as a consistent and repeated “gaslighting” by the government.

“Friday, for me, was probably my darkest day in my professional career,” says Dr. Peter Jüni, the scientific director for the Science Table—who is also a world-renowned researcher and a professor at the University of Toronto.

Jüni told me he found himself asking: “Were we not clear enough?”

“It’s pretty clear that there is a gulf between what the Science Table has recommended and what the policy announced in the province was. That’s clear,” says Dr. Isaac Bogoch who sits on the Table’s modelling working group, teaches at the University of Toronto, and who consults on infectious disease outbreaks at the Toronto General Hospital.

When the entire Table joined a Zoom call on Sunday morning, there were divergent views on what to do. Some wanted them all to resign, as a show of force that the government couldn’t use their modelling but ignore their advice.

But, as Bogoch notes, the public outcry about the measures actually prompted a retreat. The Ford government, perhaps more than the average government, is intensely sensitive to criticism. The Table’s advice—enabled by their independence, both from government and from any kind of particular hierarchy—no doubt enabled that public backlash.

There was also some pessimism about whether resigning would have much impact.

“I’m not sure, personally, what resignation would do,” Morris confesses. Bogoch agrees: They still have a job to do, he says. Being ignored “doesn’t mean you fold up your tent.”

Jüni, who publicly mused about resigning, came to a similar conclusion. “I could make a point, not a difference,” he says.

One feeling is particularly stark: The Science Table fears what, if anything, will replace their advice and modelling if they leave.

“There’s no question there are times, it has felt to many people, like we’ve been played,” Morris says. With resignation off the table, his mind turned to: “How can we avoid being played like that?”

***

What, exactly, the Ford government is going to do next is an open question. On Monday, after a brutal weekend for the Ford government, I got on the phone with someone in the Premier’s office. We agreed on anonymity so they could speak freely.

They certainly acknowledged the blowback that came from Friday’s announcement, and recognized more action would be necessary to stem the transmission of the virus. And they were quick to highlight the areas where they did, general speaking, follow the Science Table’s advice. Chiefly, Ford announced his government would dedicate 25 per cent of the vaccine supply for frontline workers in hotspot neighbourhoods.

The Science Table, I pointed out, recommended allocating 50 per cent of the vaccine supply. The government source said: Well, if we had done 50 per cent, they would have called for 75 per cent.

At another point, I noted that the Science Table was apoplectic about how virtually nothing was being done to shut truly not crucial construction projects. Yes, the source said, but the construction industry was furious.

(Indeed, the Ontario Construction Consortium attacked the government’s order barring non-essential construction, bizarrely insisting that “a recent snapshot of 10,000 Workplace Safety and Insurance Board (WSIB) claims related to COVID-19 since the pandemic began showed that fewer than 200 of those cases originated in the construction industry.” Provincial data shows that, since the start of the pandemic, some 10,000 cases were a direct result of outbreaks at offices, warehouses, and construction sites.)

But the balancing act this government is striving for is exactly the problem: Splitting the difference, or trying to strike a balance between rigorous scientific advice and the construction lobby is not a wise or successful move.

“How does a cabinet—that has even a rudimentary understanding of what’s going on—how do they deliberate over numerous hours over two days and come up with this?” Morris asked me.

“If you do half measures, you hurt everybody,” Jüni says. “Including the economy.”

The province has dedicated more inspectors for these workplaces, but its own advice is faulty: The Government of Ontario’s official policy on masks in the workplace holds that “you do not need to wear a face covering when you are working in an area that allows you to maintain a distance of at least 2 metres from anyone else while you are indoors.” (The provincial regulations state that workers may be maskless if they can maintain social distancing and are in an area inaccessible to the public—a construction site, for example.)

That is a fundamentally backwards policy that ignores the strong likelihood of airborne transmission. If workplace inspectors are continuing to enforce that standard, the inspections are going to be largely ineffective.

Things that the science table believes are going to be helpful is more support for workers, essential workers, to access support—primarily financial support so that they can get vaccinated, tested or stay away from work if they’re unwell.

When asked directly whether the government would finally retreat, and ensure sick leave for workers in the province, the government source said they were waiting to see whether Monday’s federal budget would do the job for them. Even though labour law, including sick leave, is explicitly provincial domain, they said, they wanted Ottawa to act.

The federal budget did, in fact, expand the Employment Insurance sickness benefit—but that support is claims-based, meaning it isn’t automatic nor does it mean much for an employee who suddenly falls ill. Those employees, clearly, need sick leave: Something many employers still refuse to provide, but which the provincial government can mandate.

The government source said, despite the Ford government’s dogmatic opposition to date, the government would give “serious consideration” to sick leave. But it would be unlikely any decision would be made anytime in the near future.

Part of the Ford government’s commitment to the status quo seems to stem from their belief that things are heading in the right direction. The government source said that, while things may change fast—and new ICU admissions could force their hand—they do not anticipate announcing new measures this week.

Asked where this optimism was coming from, the source pointed to the mobility data found in the Science Table’s modelling showing that, in recent weeks, fewer people have been travelling outside their home. If mobility trends downward, they think, case counts will flatten.

But that, too, runs contrary to the advice from the Science Table. “Mobility is a surrogate for contact,” Jüni says. “It’s a marker. It isn’t causal.”

As Jüni points out, declining mobility could be a sign that, through general anxiety or enforcement measures, people are staying indoors—a good sign, if social gatherings are driving transmission.

Provincial data shows that a significant number, likely the majority, of COVID-19 cases in the province are coming from workplaces and schools. I asked for data to prove that private gatherings were driving significant caseloads, but have yet to receive it.

On the flipside, however, mobility trends might not mean much if Ontarians are leaving home to engage in low-risk activity, like meeting friends in a park, or going for a walk.

The more I cited the Science Table’s work, the more the government source suggested the advice was at odds with itself. Or unclear. Or, for example, that the Table couldn’t agree on advice about the safety of gathering outdoors.

The Table doesn’t see it that way. Jüni himself presented before cabinet. “Outdoors is safe,” he told them. It can be made more safe, he added, but he says he was abundantly clear. “I do not know what more I could do,” he says.

Morris echoes the sentiment: He says it is “essential” that the province provide clear advice, encouraging outdoor activity.

***

On Tuesday afternoon, the Science Table issued a letter to the Ford government, entitled: The Way Forward.

“Ontario is now facing the most challenging health crisis of our time,” the Table wrote. “Our case counts are at an all-time high. Our hospitals are buckling. Younger people are getting sicker. The disease is ripping through whole families. The Variants of Concern that now dominate COVID in Ontario are, in many ways, a new pandemic. And Ontario needs stronger measures to control the pandemic.”

The letter put to paper, publicly, what the Table has been telling the Ford government emphatically since the third wave began swelling.

It proposed clear strategies—things the Ford government is pointedly not doing:

Reducing the list of essential workplaces allowed to remain open to be “as short as possible,” and ensuring that those workers wear masks on the job.

“Paying essential workers to stay home when they are sick.” And not, they note, the federal Employment Insurance benefit, which is “cumbersome” and inadequate.

Allocating as many vaccine doses as possible to hotspot communities and essential workers—and ensuring “on-the-ground community outreach” to connect doses to those workers.

Providing “public health guidance that works.” That means communicating a simple message: Indoor gatherings should be strictly forbidden, while underlining that “Ontarians can spend time with each other outdoors” while social distancing. That means allowing small gatherings of people from different households, while also encouraging masks and two metres distance.

The letter warns that “inconsistent policies, with no clear link to scientific evidence, are ineffective in fighting COVID.” That includes, they wrote, policies that “discourage safe outdoor activity.”

The premier isn’t mentioned by name in the letter, but the closing lines offer a stark warning for the government:

“There is no trade-off between economic, social and health priorities in the midst of a pandemic that is out of control.”

Source: How Ontario’s health advisors handled the ‘darkest day’ of the pandemic

Filed under Government Tagged with COVID-19, Justin Ling, Ontario, Ontario COVID-19 Science Table.

@Justin_Ling #COVID19: How did it come to this?

2021/04/19 Leave a comment

One of the best overviews I have seen:

After a year of struggling with this pandemic, science has developed a relatively good grasp of COVID-19.

We know that it is difficult to catch the virus from surfaces: Sanitizing your groceries and obsessively covering your hands in hand sanitizer is probably unnecessary.

We know community spread is driven, in large part, by large outbreaks and super-spreader events: Big gatherings lead to explosions of cases.

We know that indoor transmission is particularly dicey because the virus is easily aerosolized: Many people can get sick very quickly if they congregate indoors.

We know that outdoor transmission is possible, but unlikely: A combination of air flow and UV light means the virus can’t get very far.

We know vaccines are incredibly effective and safe, but that herd immunity will be needed to stop community spread: They can protect the elderly but won’t stop community spread until the vast majority of people are vaccinated.

While there’s clearly room for smart people to disagree on the details of those conclusions, they have been born out by an emerging body of science. New variants have changed the math a bit, but haven’t fundamentally altered those facts. Early in the pandemic, when these truths and solutions were murkier and less clear, absolute lockdowns, stay-at-home orders and border closures were the safe and prudent choices. Advice on washing your hands and not touching your face were reasonable, cautious, suggestions.

It’s a year later. Those five facts are now incredibly well documented in the scientific literature.

Understanding more about the virus has allowed more effective strategies to come into focus: Avoid indoor gatherings whenever possible. When they can’t be avoided, have as few people indoors as possible, keep people apart from each other, make sure they mask up, and circulate air with good HEPA filters. Where possible, move people outside—and actively encourage the outdoors as an alternative for people who may ignore good public health advice.

Those solutions, of course, are easy to write and hard to implement. Warehouses, prisons, meat processing plants, greenhouses, schools: Even when these places follow the rules most of the time, religious adherence around the clock can be hard to maintain.

So that’s why mass, randomized, testing and aggressive contact tracing is necessary to catch outbreaks before the virus moves down the chains of contact and creates new outbreaks. Shutting down those locations where the outbreaks occur is necessary. When things slip through the cracks and community spread begins, short-term circuit-breaker lockdowns should be a last resort to get cases under control.

There’s no real debate about this. These strategies work: As Atlantic Canada, New Zealand, Australia, Singapore, and a host of other states have proved them effective.

And yet, most of Canada is in the midst of a punishing third wave. Public health officials continue to insist washing our hands will get us out of this mess. Politicians warn us to stay indoors, avoid the outside.

Ontario’s health-care system is hanging on by a thread. Other provinces could be in a similar spot soon.

We are here, in large part, because many of our politicians have ignored the core facts of the COVID-19 virus and the main strategies that will clearly fight the pandemic.

Heading into the spring, off the back of the second wave, the premiers of these provinces have insisted that they were special. That they could reopen the economy—and brag to their voter base about their rosy jobs numbers—without consequence. The leaders of every province west of New Brunswick have laboured under the belief that their gyms, places of worship, and workplaces could open, even amid uncontrolled community transmission, and nobody would get sick. These governments have been sure that they have grown more clever, more agile, more adept than the virus.

Those governments have been wrong, and people have died because of it.

And when things have gone wrong, all the things governments promised us they had done turned to sand. In most of the country, mass testing was promised and not delivered—Ontario and Quebec require appointments, and have not expanded their testing capacity in any significant way since last year. Contact tracing has been essentially abandoned on a provincial basis. Circuit-breaker lockdowns didn’t touch the industries most responsible for spreading the virus.

Governments have begged us to stay at home—except if you need to go to work in an Amazon warehouse (600 cases); the Cargill chicken processing plant (82 cases); the Saskatchewan Penitentiary (more than 260 cases); St. Michael’s Ukrainian Catholic Parish, where congregants could gather without masks (10 cases); Mega Gym, which the Quebec government permitted to re-open (400 cases), and so on.

It is infuriating to find ourselves in the third wave, only to learn that we haven’t learned a damn thing.

Governments have pointed to the variants as some terrifying change in the equation. And, yet, look at Ontario’s data: This is just a ramped-up version of the same virus we’ve been fighting since March, 2020.

In late February of this year, in the lull between waves, nearly 60 per cent of cases could be attributed to a specific outbreak and/or a close contact of someone who tested positive. (A bit more than a third of cases had no known epidemiological link, a failure in and of itself.) In late March, as the third wave was in full swing, that proportion remained unchanged.

Where those outbreaks have occurred haven’t changed much, either.

Around 30 per cent were in congregate living or care spaces: Hospitals, prisons, shelters. Around 30 per cent were in schools. The remainder, about four-in-10 outbreaks, were workplaces.

Recently, Ontario has provided more visibility on the types of workplaces experiencing outbreaks: Hairdressers, restaurants and retail stores are responsible for vanishingly few superspreader events—between the three, they caused just eight per cent of overall outbreaks.

Even as case counts were climbing, and outbreaks were being reported across the province, people congregated on patios at bars and restaurants. In mid-March, before that naughty behaviour was banned, bars and restaurants reported eight outbreaks across the province: 37 cases in total. (This proportion hasn’t changed since last summer, when case counts were low and bars and restaurants were open.) That same week, there were 66 outbreaks in warehouses, food processing plants, and farms: 479 cases.

Dig into the data, as the Globe & Mail has done, and the absurdity becomes more acute: these outbreaks are happening in facilities that manufacture sporting goods. A retail marketing firm. An Amazon warehouse.

Many outbreaks also occurred in settings run by governments. There has been widespread transmission of the virus inside prisons and jails—which governments have been criminally inept at preventing. Shelters, too: Ontario’s data shows there are 32 ongoing outbreaks in shelters across the province.

This story is about the same from one province to the next. The data speaks for itself: Workplaces and schools are driving transmission of this virus. Were the whole country to lock themselves in their closets, except for those students and “essential” workers, the crisis would continue.

An emerging body of research explains what’s happening here. From the start of the pandemic, leaders have told us that the concern is about the transmission of droplets—and, rightly so, because the early science suggested that saliva particles from speaking, coughing or sneezing was the main driver of transmission. Good science is increasingly telling us that the virus is aeresolized.

That means we ought to be less fearful of tiny blobs of the virus covering everything—our hands, our faces, our picnic blankets—and more worried about the air around us. If you think about the virus that way, it becomes immediately obvious how much less risky it is to sit with some friends for a picnic, or on a restaurant patio. Conversely, how risky it is to run a warehouse with hundreds of workers, exerting themselves.

Have governments addressed this? No. Instead, governments have proffered curfews, as though the virus hunts at night. Parks have been closed. Camping has been banned. Outdoor mask mandates have been implemented. Outdoor gatherings limited. Police patrols to harass people out for walks.

Even as projections have shown Ontario teetering on the brink of a deadly crisis, Premier Doug Ford’s solution was to limit outdoor gatherings and to shut outdoor recreation sites.

But here’s the rub: Provinces know outbreaks aren’t happening in parks, or on patios. Quebec public health officials have acknowledged that they have no evidence to prove transmission is happening outdoors. Peer-reviewed studies have said that, on the high end, some eight per cent of global COVID-19 cases were linked to transmission outdoors. On the other end, Ireland studied its own data and found 0.1 per cent of cases occurred outside. Air quality monitoring done in Italy in the height of the second wave found the prevalence of the virus in the open air waseither negligible or not high enough to lead to transmission. (Though researchers admitted that dynamics could change in very crowded areas.)

Scaremongering about outdoor transmission, and instituting curfews is a feat of social engineering. This an effort to ignore the data, withhold information, and twist the facts to scare us.

The conspiracy-minded will see that as an exercise in population control: Politicians getting their jollies off by playing dictator.

The reality is more mundane—governments are doing this because they are frozen with indecision. Actually acknowledging the reality of the data means acknowledging this catastrophe was caused by governments’ idiotic reopening plans: Plans that were warned against by public officials at the time. Doing that means taking action that will hurt employment numbers, which could hurt our politicians fragile egos. Confronting this data and science also means admitting that all of our advice about washing your hands and not touching your face has been useless. And accepting that reality means provinces requiring sick leave, so people can go home if they’re ill.

Governments are loath to do any of that. They would rather shower us in meaningless pablum about how we, as citizens, need to do our part. The implication, of course, is that we are to blame for this crisis. That it’s us wayward youth who are driving this pandemic. Our lack of personal responsibility means they have to ground us to our rooms. Stay home, for god’s sake!

If our politicians stop blaming us for outbreaks, we may start blaming them.

And for good reason.

We need to stop talking to people like they are infants to be controlled. Especially when the politicians issuing these stay-at-home orders have zero credibility with which to be lecturing anyone. Any bit of trust people have in Doug Ford, Francois Legault, Scott Moe, Brian Pallister, and John Horgan has been shredded, and lit on fire.

In Atlantic Canada, the territories, and in Indigenous communities across the country, politicians of various political stripe show what real leadership looks like. How effective management means trusting the public while also accepting responsibility.

The rest of our provincial politicians need to act immediately to undo the damage they have enabled. Businesses need to be shut, unless they are absolutely essential. Those that need to remain open need stringent measures to deal with air quality. Given the pressure it puts on parents and students, schools should probably remain open: But, again, actual measures need to be taken to reduce the risk of that aerosolized transmission.

And we need to provide clear, coherent advice to people on what to do. Advice that follows the science.

We need to avoid indoor gatherings as much as possible. We should wear masks whenever possible. We should give each other two metres of distance. We should stay home when we have any symptoms, check our temperatures daily, and get tested if we feel sick.

But we also need to tell people what is safe. And it is very safe to go outside—it is extraordinarily safe, in particular, if you give people a little extra space and avoid crowded areas.

Have a picnic. Hold a barbecue in your backyard. Go for a walk. Play tennis. Go camping.

People need hope. Lying to them won’t engineer a solution. Politicians need to do their job.

Source: How did it come to this?

Filed under Government Tagged with COVID-19, Justin Ling, Ontario

Remaking the public service: After a year of COVID, what has the federal government learned about how it operates?

2021/04/16 Leave a comment

Useful and informative overview:

Not since the Second World War has the federal government loomed so large over the affairs of Canadians. During the first ten months of the pandemic — from April 1, 2020 to January 31, 2021 — the government shelled out half a trillion dollars compared to $287 billion during the same period in 2019.
The vast majority of the increase was courtesy of emergency spending on an extraordinary range of anti-virus measures.
About $78 billion was taken up by programs to help individuals directly affected by COVID-19. Another $66 billion went towards subsidizing wages of employees who would otherwise be laid off. Billions more were directed at shoring up the weakening balance sheets of small business, and to secure vaccines, testing equipment and personal protective gear.
At times, it seems scarcely a segment of the economy has been left untouched by Liberal government largesse, which by the end of January had pushed the federal net debt to $1.1 trillion. This represented more than half the country’s gross domestic product, not a record by any means, but up from less than one-third practically overnight. This does not include the rapidly deteriorating balance sheets maintained by the provinces.
While the potential risks associated with this level of debt have been put off until the virus has been tamed, the impact of the sudden spending spree on government operations has been profound.
In the year of COVID, dozens of federal agencies and departments have been forced to behave in starkly uncharacteristic ways.
Deep-rooted policies were re-crafted on the fly, procurement moved at warp speed and multiple departments were tasked with building a health products industry nearly from scratch.
On top of this, key ministries are about to be tasked with managing an ambitious program, to be outlined in the April 19 federal budget, to refurbish the country’s infrastructure and help jumpstart the post-COVID economy.
Behind the scenes, government executives are ramping up plans for modernizing operations. They are also asking themselves what permanent lessons they should draw from the tumult of 2020.
These range from the profound: how to prepare for a new pandemic, to the practical: how should government better organize itself for the digital world?
The first lesson involves drilling into the overarching weakness of Canada’s response to the coronavirus — not just the egregious intelligence failure of the Public Health Agency of Canada, but also the relaxed oversight of a cabinet that could not bring itself to accept a worst-case scenario.
PHAC had assured Canadians the health risk to them was low early last year even as the coronavirus was circulating widely.
At heart, this was a failure of leadership culture, not a lack of early warning. The infection that became known as COVID-19 was in plain sight from the start. What PHAC missed, or at least declined to act upon, was the fact that COVID-19 was spreading asymptomatically, despite evidence that had been brought to its attention.
The result was a sharp, early rise in the number of infections, followed by a sub-par rollout of COVID-19 vaccines, which reflected a general lack of preparedness.
For other departments and agencies, the lessons of COVID are more straightforward.
The rapid spread of the coronavirus has demonstrated clearly the importance of the digital world. While the federal government has built one of the country’s largest communications networks, much of it is in need of refreshing and very little is easy to use.
The technology gaps were particularly shocking when it came to tracking stockpiles of personal protective equipment, conducting tests for the coronavirus and tracking the networks of people affected. This was both a provincial and federal government failure.
Anxious to avoid a repeat, federal departments in the past few weeks have developed ambitious plans for upgrading their infrastructure, and expediting new online services for Canadians. Whether these actually succeed will depend heavily on the government’s willingness to reverse its traditional antipathy for investing in operations. Encouraging executives to bear direct responsibility for projects will help.
“The path set out during the early days of the pandemic points to a new way of doing business,” the Canada Revenue Agency declared in its priorities report for the fiscal year ending March 31, 2022.
The agency, which spends half a billion dollars annually on information technology and was a key player in the delivery of the Canadian Emergency Response Benefit, is making permanent adjustments to its networks to give it more flexibility in the event of future crises. It is also developing a series of software applications to simplify tax returns, permit more tax verification information to go online and automate more of the tax filing process.
Employment and Social Development Canada is managing a massive, multi-billion dollar upgrade of the systems that deliver Canada Pension Plan, Old Age Security and other payments. While that was in train before the pandemic, the urgency has increased.
“Past decisions to defer maintenance and updates have increased the risk of systems failure,” the department noted bluntly in its most recent plan, “Modern applications need up-to-date technology.”
During the first few days of the economic lockdown a year ago, ESDC’s system for delivering employment insurance claims very nearly crashed. The department now has in place a program for accelerating its investments in information technology until 2026 to try to make up the gap in its capacity.
ESDC is hardly alone in playing catch-up.
Federal departments across government currently maintain some 14,000 software applications, ranging from weather forecasting to applications for business loans. Many are built on technology so old the original providers have simply stopped supporting it. In order to keep the entire apparatus humming, the government relies on thousands of software jocks familiar with products now past their prime. Many are employed by private sector specialist firms.
“We have to deal with the legacy stuff we inherited, fix it, replace it, modernize it,” Shared Services president Paul Glover acknowledged last fall before a House of Commons committee.
One way to look at it: older software programs need to be upgraded or replaced before they can be shifted from legacy locations to one of the pristine data centres now up and running. To date, just five per cent of the workloads associated with the software have migrated from old data centres to new ones, with another 40 per cent in various stages of planning.
What’s needed, in other words, is a concerted effort to modernize government faster than it’s aging. Departments and agencies will have to stretch.
Thanks to the experience of COVID-19 they now understood just how quickly they can move. Some of the more inspiring examples include:

Canada Revenue Agency and ESDC developed generous financial assistance programs for millions of Canadians in a matter of days.
Shared Services Canada boosted by 50 per cent the capacity of its networks serving Canadians online, and doubled to nearly 300,000 the number of secure connections used by government employees working from home.
Global Affairs seconded more than 600 employees to an emergency response centre at Lester B. Pearson headquarters. There they organized the repatriation of more than 60,000 Canadians from 100 plus countries in the largest post World War II exercise of its kind.
Public Services and Procurement Canada — the government’s contracting arm — arranged for the flights for repatriated nationals, and negotiated billions of dollars’ worth of medical supplies, testing equipment and other gear on behalf of the Public Health Agency of Canada. PSPC managed all this with a 3 per cent bump in the size of its procurement group.

So it was, across government. While Canadians in other parts of the country were suspicious that thousands of federal employees had simply booked time off for a COVID holiday, things actually got done.
Yes it was messy. Mistakes were inevitable in this environment, the prime minister acknowledged, but these would be corrected later, he promised. Indeed Canada Revenue Agency and ESDC are conducting audits of the billions of dollars of emergency payments, an exercise that will rely to some extent on artificial intelligence software.
Dealing quickly with the vast knock-on effects of COVID-19 was considered more important last year than upfront due diligence — an assessment with which Auditor General Karen Hogan agreed.
In some ways the government was lucky. Had COVID-19 struck a few years earlier, the response might have been an unholy mess. As recently as 2018, Shared Services Canada, the core supplier of data centres, Internet service and telephone networks, was working itself out of a deep hole created when Stephen Harper’s Conservatives cut its budget just as the department was launched.
The government only recently put in place a cloud services program with third parties, allowing departments to quickly expand network capacity in emergencies. It’s what saved the CERB program.
Just as fortunate, federal departments have been experimenting with pilot projects — such as work-from-home arrangements and automatic bank deposits — that allowed near instant responses to COVID developments.
These signs of flexibility and speed were the fruit of an extraordinary exercise in workplace consultation.
In June 2013, Wayne Wouters, the government’s top mandarin and clerk of the Privy Council asked federal workers what they thought of Blueprint 2020 — an analysis of global trends in technology and management. The document set out a series of principles that would govern how employees would do their jobs in light of these new realities.
The gist was that in order to properly serve Canadians by 2020, government workers would be equipped with state-of-the-art technology, and encouraged to be flexible, to experiment with ideas, and collaborate with other departments. They would also be given freedom to make mistakes and to learn from them.
More than 100,000 offered their views, most of them keen on the idea of making a difference. Others viewed the exercise with scepticism. They knew that as long as politicians felt they had to answer for errors in their departments, the business of running government would default to avoiding risk. Top-down management would prevail. In many ways, it still does.
Yet, fitfully, and somewhat improbably, the work culture began to shift. Here and there, departments and agencies set up those pilot projects. Government planners lost their enthusiasm for huge, all-encompassing programs following the botched rollouts of Phoenix Pay and email systems for federal employees. Both of these had been launched prior to the publication of Blueprint 2020.
Instead, the government has encouraged minimalism — the idea that new online services for Canadians or government employees should be developed in more manageable stages, with each one tested before moving to the next.
When responding to COVID, of course, there was little time for testing. But even there, the lessons of Phoenix Pay had been absorbed. In developing the Canadian Emergency Response Benefit for millions of people affected by the virus, the Canada Revenue Agency aimed for what it called a “minimum viable product” — a software application stripped to absolute essentials.
Along with making changes to the government’s electronic backbone, departments are wrestling with how to deploy their workers, post-COVID.
The Canada Revenue Agency — with 45,000 employees, including some 12,000 in the capital region — is also taking the lead on creating a permanently distributed workforce. In response to queries by this newspaper, the agency said it is looking to shift towards “a hybrid model” that will see a certain core work full-time from the office, while giving other employees the flexibility to work from home.
The collective decisions will have a profound effect locally. Not only do federal government employees make up more than 20 per cent of the Ottawa region’s total workforce, they work in buildings that account for nearly 30 per cent of the capital’s commercial real estate.
Managers and workers alike have learned much of their work can be done from anywhere, leading some to query why 42 per cent of the government’s 300,000 civilian employees need to be based in the national capital region. Departments with more than 80 per cent of their workforce located in Ottawa or Gatineau include: Finance, Statistics Canada, Treasury Board, Innovation and Global Affairs.
Real estate planners suggest the government’s future workforce will likely be split into three groups: small minorities who choose to work permanently from home or the office, and a majority who will work remotely for part of the week.
With thousands of work rules at play across dozens of union bargaining units, none of this will be easy to sort out.
“The work office will have to be re-thought,” says Stéphane Aubry, national vice-president of the Professional Institute of the Public Service of Canada, which represents 60,000 government workers. “Some of our members will prefer to keep working at home,” he adds. “We will not be going back to what was before.”
Before the pandemic struck, the government had been nearing the end of a multi-year program to reduce the amount of office space available for each employee. Almost certainly this strategy will be reversed to accommodate workers still concerned about working in close proximity with colleagues. This means fewer workers for the same amount of office space.
This won’t necessarily be a problem, at least in terms of logistics, assuming sufficient numbers of employees work from home. But it will likely increase overhead costs for government workers overall.
In coming years, as the government starts winding down its spending, the nearly $50 billion it spends annually on payroll for permanent staff will likely come under increasing scrutiny, not to mention the $11 billion it spends each year on professional services.
A strong counter-argument would be to point to a sprawling organization that, prompted by COVID, learned to serve Canadians with dispatch and efficiency. Will it actually happen?
Put it this way: the federal government over the past decade wasted billions of dollars of taxpayers’ money on failed information technology projects — and both government and private firms were at fault.
Departments now have another opportunity to get things right and rehabilitate their reputations. Many of the pieces are in in place but the big unknown is whether the flexible culture foreseen by Blueprint 2020 will actually be permitted to flourish.

Source: https://ottawacitizen.com/news/postpandemic/remaking-the-public-service-after-a-year-of-covid-what-has-the-federal-government-learned-about-how-it-operates

Filed under Government Tagged with COVID-19, James Bagnall, Public service

Germany Is Expected To Centralize Its COVID-19 Response. Some Fear It May Be Too Late

2021/04/14 Leave a comment

Uncomfortable parallels with Canada? That being said, unclear whether stronger federal role would have avoided some of the provincial mistakes and/or denial about the risks of a third wave:

This week, German Chancellor Angela Merkel is making good on a veiled threat she issued two weeks ago to centralize pandemic management. Amid growing calls for Merkel to take control of the situation and bypass the country’s 16 state leaders, Germany’s parliament is expected to pass a measure this month that will allow her finally to take charge of the country’s COVID-19 response.

As the third wave of infection rages, some worry it may already be too late. Hospitals in Germany warn they’re about to run out of intensive care beds, even as state leaders continue to relax coronavirus restrictions.

Germany, with a population of 83 million, has lost nearly 79,000 lives to the pandemic. With the more contagious B.1.1.7 variant now dominant, the national seven-day incidence rate has risen in recent weeks from below 100 to 136.4 cases per 100,000 people. The country’s total number of infections has surpassed 3 million.

A year ago, Germany was weathering the pandemic relatively well and Merkel’s coronavirus response — attributed to her scientific understanding of the virus and a robust test, track and trace system — was praised far and wide. But exponential growth has long since overwhelmed virus trackers, and the slow start to vaccine rollout, combined with an increasingly confusing patchwork of regional lockdown regulations, has left the country in epidemiological disarray and sent Merkel’s party plummeting in the polls, losing 10 points in recent weeks.

“It’s been a bit of a rude awakening for us Germans to realize that we’re not the masters of organization,” says Melanie Amann, who heads the Berlin bureau of Der Spiegel.

While the pandemic has debunked the myth about German efficiency, the same cannot be said of another cliché — the nation’s love of red tape.

“Our ability to create complex systems and bureaucracy have pretty much stopped us from effectively fighting the pandemic,” Amann says. Nonfunctioning websites, unstaffed hotlines, excessive paperwork and authorizations are among the issues she cites — amid regulations that differ from state to state.

Severin Opel, a 23-year-old Berlin resident, had to wait several days to get an appointment for a recent rapid coronavirus test.

“Paperwork is getting in the way of this pandemic,” he laments. “There’s so much focus on minutiae and documenting every step to the nth degree, guidelines end up contradicting each other and nothing makes sense.”

Merkel is known for her careful, measured responses to crises, but even she admits there’s sometimes too much devil in the details.

Speaking in a rare television interview last month, Merkel conceded: “Perhaps we Germans are overly perfectionist sometimes. We always want to do everything right because whoever makes a mistake gets it in the neck publicly.” But “in a pandemic,” she went on to say, “there needs to be more flexibility. We Germans need to learn to let go.”

Janosch Dahmen, a front-line doctor and health spokesperson for the Green Party — which is close to rivaling Merkel’s conservatives in the polls — believes the government’s cautious approach is actually reckless.

“A strategy or intervention without risks doesn’t exist,” Dahmen says. “Waiting for the perfect, flawless game plan is a recipe for failure, especially in the face of this virus, which is mutating insanely fast.”

And yet Merkel’s crisis management style is only one factor. Germany’s system of federalism means she has little say in the country’s vaccination and lockdown strategies, of which there are no fewer than 16 — one for each German state.

Amann argues, though, it’s high time that Merkel — who leaves office this fall — used her considerable political capital to take charge, rather than simply advising and negotiating pandemic guidelines with the 16 state premiers.

“Because her term is ending, she theoretically has all the freedom and all the independence she wants to take bold steps in the corona management,” Amann says. “Nobody could run her out of office. And she’s not using this. She’s just working as if she were at the beginning of her first term.”

State leaders agreed in March on an “emergency brake” strategy to impose more rigorous measures as infections rose, but the agreement was only in principle, and few states have implemented the measures strictly.

After weeks of frustration, political commentators have observed, Merkel looks the way many Germans feel — namely mütend, a pandemic-era mashup that means both tired (müde) and angry (wütend).

And while there’s concern that parliament might take too long to pass a bill allowing Merkel to streamline and centralize pandemic crisis management, the chancellor and most of the state premiers agree the current situation is untenable.

Source: Germany Is Expected To Centralize Its COVID-19 Response. Some Fear It May Be Too Late

Filed under Government Tagged with COVID-19, federalism, Germany

@Justin_Ling: Canada’s public health data meltdown

2021/04/09 Leave a comment

Good long read, highlighting ongoing policy failure at both federal and provincial levels:

For weeks, Canadians have been casting their envious eyes to Israel, where more than half the country has been inoculated against COVID-19. Israel, less than a quarter the size of Canada, has administered nearly twice as many doses of the COVID-19 vaccine.

The Middle Eastern country has some innate advantages: It is small and centralized, and offered top dollar to ensure vaccines from Pfizer and Moderna would come fast, and in large volumes. But geography and money aren’t the reason why Israel is outpacing Canada by 10-to-one.

Israel has the vaccines because it has the data.

In its shrewd deal with Pfizer, Israel offered to turn the country into one giant clinical trial: Providing the vaccine manufacturer unprecedented large-scale visibility as to the vaccine’s efficacy. It’s all made possible because of the country’s state-of-the-art information technology and robust national vaccination database.

The rest of the world is currently benefiting from that incredibly granular information.

Canada could never have struck such a deal. Its health technology is, charitably, a decade out of date. It lacks the ability to adequately track infectious disease outbreaks, efficiently manage vaccine supply chains and storage, quickly administer doses, and monitor immunity and adverse reactions on a national basis.

Even though all the shipments of vaccines arriving in Canada come with scannable barcodes, to make tracking and logistics easier—with some manufacturers even barcoding the vials themselves—no Canadian province can scan them. In many provinces, pharmacies can’t access the provincial vaccine registry. Provinces do not automatically submit reports on COVID-19 cases or vaccines into the federal system, and must submit reports manually. Many crucial reports are still submitted by fax: Where fax has recently been phased out, they have been replaced by emailed PDFs.

Ours is a dumb system of pen-and-paper and Excel spreadsheets, in a world quickly heading towards smart systems of big data analytics, machine learning and blockchain. It’s unclear how Ottawa will be able to issue vaccine passports, even if it wants to.

At the core of the omnishambles is a simple fact that Canada has no national public health information system, but 13 different regional ones. Many of those regional systems have smaller, disconnected, systems within: Like a Russian nesting doll of antiquated technology.

But there’s good news: It doesn’t have to be this way. In some parts of the country, real progress is being made. Small technology start-ups are figuring out cheap, scalable and innovative solutions. In some provinces, progress can be as simple as updating operating systems.

If we are ever going to build efficient, cost-effective, and effective health infrastructure, Ottawa needs to take the lead. We need to abandon the idea that federalism requires us to have each sub-national government run entirely independent, walled-off, health databases.

We need data sharing. We need shared infrastructure. We need a national public health system.

***

For decades, Canada has been building out computer systems designed to track infectious disease outbreaks and vaccination campaigns. In non-pandemic times, that means monitoring the spread of sexually transmitted infections, keeping track of supplies of vaccines for things like influenza and mumps, and keeping an eye out for novel outbreaks of infectious diseases.

Most of the country relies on a public health system called Panorama, but not everywhere: Alberta, P.E.I., Newfoundland and Labrador, Vancouver Coastal Health, and the Public Health Agency of Canada itself all use other systems.

The provinces and territories that do have Panorama use it to varying degrees. From one province to the next, the heath infrastructure has different names, different features, unique customizations and varying capabilities.

This was never the plan. Canada, in fact, was once a world leader in digitizing its public health infrastructure.

In 1996, at a national conference of health officials, it was decided that “an immunization tracking system is urgently needed in Canada.” It included a list of goals: To identify children in need of vaccination, to book appointments, to do population-level analysis of immunity to diseases, and so on.

In 2002, basic national standards were drafted: “The time has arrived for a national program to be administered provincially, thus ensuring compatibility between provinces so that this health care information can be accessed when needed.”

When SARS hit Canada in 2003, before any of this technology could actually be implemented, health authorities found themselves woefully unprepared. The federal government and province of Ontario tried to manage the epidemic relying on “an archaic DOS platform used in the late 80s that could not be adapted for SARS,” per an Ottawa-commissioned report.

The country had only gotten a taste of what a deadly and hard-to-control infectious disease outbreak looked like. And it wasn’t ready. It only underscored just how crucial this national database was. The solution to that was Panorama.

It wasn’t cheap. Paul Martin’s government committed $100 million in its 2004 budget to seed the creation of Panorama, through the not-for-profit, government-funded Canada Health Infoway. His government also created the Public Health Agency of Canada to ensure there was central preparedness for the next SARS.

“With this budget, we begin to provide the resources for a new Canada Public Health Agency, to be able to spot outbreaks earlier and mobilize emergency resources to control them sooner,” then-finance minister Ralph Goodale said in his budget speech. He promised “a national real-time public surveillance system.”

The subsequent Harper government, seemingly recognizing the wisdom of what his predecessor had started, provided another $35 million more to fund the work. The contract to build this national surveillance system would ultimately go to IBM Canada.

In 2007, Canadian health officials flew to a conference in Florida to tell their American colleagues how far ahead we were on this health technology.

“By 2009 there will be a national surveillance system that will include a network of immunization registries,” their powerpoint presentation said. They broke down how it would work: A vaccinator would enter a patient’s information, scan the barcode on the side of the vaccine vial, and it would all go straight into the provincial database and, later, the federal system. A computer system could manage an outbreak from infection to immunity.

Dr. Robert Van Exan, who ran health and science policy at Canadian vaccine giant Sanofi-Pasteur, was tapped by Ottawa to figure out how to effectively barcode vaccines in the early 2000s.

“Technically, it’s a huge challenge,” Van Exan told me when I interviewed him in March for the Globe and Mail. “At least, it was.”

At the manufacturer, vaccines moved along a conveyor belt at a rate of about 300 to 1,000 vials per minute, he explained—adding new labelling was a logistical nightmare. But, within a few years, he had corralled the technological know-how to get it working. He went back to the federal government, excited that he and his company were part of this digital revolution.

“Canada was ahead on this by a decade,” Van Exan told me.

But through the late 2000s and early 2010s, that plan seemed to fall further away. There were delays and cost overruns, which largely fell to the provinces and territories. In 2015, British Columbia’s auditor general reported that the province had budgeted less than $40 million to build and maintain Panorama. The cost wouldn’t just double: It nearly tripled. The B.C. government alone would pay more than $110 million, not including ongoing annual costs.

As the program struggled, the Public Health Agency of Canada—the body specifically created following SARS to help build a national public health strategy—pulled out of Panorama. It let the provinces and territories fend for themselves. Nobody was left to actually enforce those brilliant minimum standards from years earlier. It stopped being a cross-compatible national system, administered provincially, and became a smattering of incompatible systems with no real national buy-in at all.

Provinces like Alberta bailed on Panorama in frustration.

The provinces and territories that stuck with it wound up with an inferior product. Beyond just the increased costs, the devastating report from the B.C. auditor general found that core components were just missing. Online vaccine appointments? Vaccine barcoding? Offline usage? Federal integration? All those features were promised, but “not delivered.”

“The system cannot be used to manage inter-provincial outbreaks, the main reason for which the system was built,” reads one particularly galling passage.

Other features didn’t work, or had severe limitations.

Van Exan recalls how “fed up” the vaccine industry was with Ottawa. “They went through this trouble to put the label on the vials,” he said. And for what?

“Despite a substantial federal investment,” one peer-reviewed study pointed out in 2013, “Canada continues to lag behind other countries in the adoption of public health electronic health information systems.” A 2015 study found that multiple provinces failed to even meet the minimum standards set out in 2002—standards that were already becoming stale and anachronistic.

Those 2002 national standards haven’t been updated since. (Health Canada told Maclean’s that the most recent standards were issued in 2020, although the document it pointed to clearly labels them as recommendations for new standards.)

Whether the standards are from 2002 or 2020 is somewhat immaterial. Ottawa doesn’t even know to what degree the provinces follow the standards.

The standards clearly call for Canada to have “reliable digital access and exchange of electronic immunization information across all health providers with other jurisdictions (including federal).”

In response to a question submitted in the House of Commons, Health Canada wrote last summer that “it is not possible for the federal government to know the details of any of the configurations of the provincial/territorial instances of Panorama in order to judge whether it meets a particular standard.” The Public Health Agency has not performed an audit of Panorama, the government added.

There are lots of reasons for the boondoggle. Many provinces and territories had competing priorities for what their health infrastructure ought to look like, and many balked at the idea of sharing data with Ottawa or even their neighbouring governments. “The provinces chose to do things independently,” said one source with knowledge of the system, who spoke on the condition of anonymity. Some provinces tried to make Panorama “too many things to too many people,” they said, and ended up with a system that disappointed everyone. That’s a common problem in Canadian technology procurement.

Part of the issue was the technology itself. Canada tried to stand up an ambitious IT infrastructure at a time when things like cloud hosting and barcoding capabilities were still expensive, clunky and hard to do on a large scale. But the core problem was a total lack of leadership. Ottawa pioneered the idea for a national registry, then walked away when things got hard.

Ontario family doctor Iris Gorfinkle has been calling for this national strategy for years. Last year, before we even saw our first vaccine, she warned in the Canadian Medical Association Journal that “it is imperative that we have the ability to provide potentially limited vaccines to those jurisdictions with higher disease rates to optimize vaccine distribution and coverage.”

I asked her why we haven’t been able to do this. She answered in a word:

“Inertia.”

***

In the last decade, provinces have had to make do. Alberta has modernized the legacy system it reverted to when Panorama went sideways. Ontario has tried valiantly to customize and upgrade Panorama until it resembled the system the province ordered.

Over time, however, Panorama did improve. By about 2017, IBM was finally adding those features that had been left off. It built out new data dashboards, integrated barcode scanning, and added APIs to make Panorama compatible with other systems. Most critically, Panorama went from a clunky program that could only run on designated computers to a cloud-based program that could be accessed by any laptop, tablet or phone.

Indigenous Services Canada, which administers some health services to First Nation communities, actually won an eHealth award in 2014 for its implementation of Panorama. One B.C. public health official lauded the agency’s work, saying it would allow health professionals “to better detect early signs of outbreaks by enabling sharing vital information between different public health related services providers.”

Some provinces, like Nova Scotia, upgraded Panorama into the new, more functional version. “One of the great things about Panorama in terms of helping in an outbreak is just having more timely access to information,” a prescient Nova Scotia provincial health official told CBC in 2019.

But it hasn’t been uniform: Ontario’s heavily customized system is running an old version of Panorama. Saskatchewan still hasn’t implemented core Panorama modules, like the one that tracks adverse reaction reports.

One source said provinces could enable its system to scan barcodes and health cards with a flip of a switch—several provinces, the source said, actually refused, insisting manual entry was more efficient.

Meanwhile, provinces and territories are still relying on manual data entry and spreadsheets to track inventory and shipments. Some jurisdictions are logging immunizations with pen and paper. A citizen can’t readily carry their immunization record from the Northwest Territories to Yukon.

Pharmacists in Ontario need to enter every immunization into two systems: once, into their own record management program; and again, into Ontario’s newly fashioned COVaxON, a front-end interface that is supposed to feed into Ontario’s outdated version of Panorama.

The inefficiencies are glaring. But it gets worse.

Notwithstanding inefficiencies and outmoded technology on the local level, the whole point of the Public Health Agency of Canada is to be able to track infectious disease outbreaks across the country. Right now, this is top of mind, as we wait to see the countervailing impacts of the COVID-19 variants and vaccines. A good system should be able to show us how different variants are spreading, and whether any or all of the vaccines are effective against which strains. But that only works if PHAC has the data.

Ottawa technically has information-sharing agreements with the provinces, but a government response to a question filed by Tory MP Scott Reid exposes how archaic the infrastructure truly is. Ottawa “does not have automatic access to data held in [provincial and territorial] systems, including Panorama,” the government wrote. “In the early weeks of the outbreak, some provinces were sending case information to PHAC via paper.” For the first four months of the pandemic, Ottawa wasn’t even collecting basic data on COVID-19 cases, like ethnicity, dwelling type, or occupation. Things have improved somewhat: Provinces now submit their reports manually, via a web portal.

The Public Health Agency of Canada reported that its “emergency surveillance team receives electronic files in .csv format from provinces and territories.”

A March report of the federal auditor general found that “although received electronically from provincial and territorial partners in the majority of cases, health data files were manually copied and pasted from the data intake system into the agency’s processing environment.” The audit also reports that many aspects of Ottawa’s data sharing agreements with the provinces and territories are not yet finalized. The audit further found that crucial information about COVID-19 cases—such as hospitalizations and onset of symptoms—was often not being reported to Ottawa.

The auditors came to a similar conclusion to many experts, like Gorfinkle and Van Exan: “We found that for more than 10 years prior to the COVID‑19 pandemic, the agency had identified gaps in its existing infrastructure but had not implemented solutions to improve it.”

When it comes to any vaccine, there are reports of adverse reactions—while they are rare, the recent panic over the AstraZeneca vaccine and blood clots shows this tracking is absolutely crucial. When a Canadian reports an adverse reaction to any vaccine, the province must pass it onto PHAC—which must, in turn, send it to the World Health Organization. Until very recently, Ottawa required that provinces and territories submit those reports via fax. More recently, it has modernized: “provinces and territories submit data [on adverse reactions] in a variety of formats, including line list submissions and PDF submissions,” the government said. That still means the reports must be entered manually. Some provinces only submit their reports weekly.

Panorama, meanwhile, has an adverse reaction tracking and reporting feature. PHAC just hasn’t been using it.

PHAC insists it has “well-developed surveillance and coverage information technology” and it responded to the auditor general with further more promises to address the gaps it has been vowing to fix for a decade. It’s hard to know if that progress is real or not.

In November—already some eight months into the pandemic—the federal government sent a secret request for proposals to a shortlist of pre-qualified suppliers looking for a “mission-critical system” to manage vaccine supply chains, inventory, and to ”track national immunization coverage.” The $17-million contract went to Deloitte, and it is supposed to plug into the disparate provincial systems to provide some semblance of a national picture. But Ottawa is refusing to disclose any timelines, details of the project or really anything beyond some boilerplate talking points. We only know about the project because the request for proposals was leaked to me in December. (“It’s awe-inspiring that they would withhold that information,” Gorfinkle says. I agree.)

So long as we commit to this madly off in all directions strategy, Ottawa can’t build a functional national system. Federal agencies can’t coordinate, much less individual provinces and territories. The patchwork makes national visibility impossible. Worse than a garbage-in, garbage-out problem—provinces can’t even agree on how to format the garbage. The result has been error and inefficiency.

One Ontario woman was hospitalized after receiving three doses of a COVID-19 vaccine, two of them just days apart—something that would never happen if she had an accessible, up-to-date vaccination record.

Meanwhile, seniors have been forced to stand in line for hours in Toronto, as health staff waste time doing work that could be easily automated. Epidemiologist Tara Gomes tweeted that her mother “had to repeat her address so many times to the person at check-in that she finally asked for a pen and paper and wrote it down.” It gets more frustrating when you realize, as Gomes noted, that her mother had to provide her personal information to get the appointment—the province’s COVaxON booking portal doesn’t connect to the COVaxON vaccine registry.

“You can’t blame one government,” Van Exan says. Every level of government of every political stripe has let this Frankenstein’s monster of a digital health system continue to limp along.

”Including the current one.”

***

The barriers to improvement are lower than you might think.

There is no particular reason why Vancouver ought to be using different vaccine management software than Victoria, or why Toronto should be running a different version of Panorama than Halifax. The diseases these health authorities face are the same, as are the vaccines dispatched to combat them.

Ottawa seems, a year after the start of this wretched pandemic, to be coming around to that idea. The Public Health Agency of Canada told Maclean’s it will finally be adopting Panorama, which “will enable more automated and timely data sharing and reporting.” At the end of March, it wrote that the new system “is expected to be online in the coming weeks.” Deloitte, IBM and the Government of Canada have been working together to get Panorama working with the Public Health Agency’s existing systems.

But just adopting Panorama isn’t nearly enough.

Step one is deciding if we really want a national system. If the provinces and territories are truly, completely incapable of running a system to national standards—or Ottawa is incapable of managing those standards—then maybe we should actually commit to decentralization. Shut down PHAC and download money and responsibility for public health to the provinces.

The benefits of a national system, however, are real and obvious. If we can agree with that principle, then step two is picking a technology and sticking to it.

We shouldn’t be married to sunk costs: If there is a better system out there than Panorama, we should consider it. But actually committing to Panorama is the obvious choice. It is already the standard for most of the country, and there’s no guarantee that starting from scratch will rectify our jurisdictional issues. What’s more: A list of other countries are now relying on Panorama. The more customers, the better.

Sticking with Panorama doesn’t mean that Alberta and Vancouver need to abandon their proprietary systems—but it does mean they need to be speaking the same language.

To that end, step three is standardizing data collection and sharing.

This, of course, needs to be done wisely: Patient data should be anonymized, for security reasons. Any cloud systems must have their servers within Canada (Nova Scotia’s data is available on the cloud, but entirely located in Halifax and Quebec.) And we need to make sure that governments are entirely transparent about how, when and why they use this aggregated health data. But all those jurisdictions need to use the same file formats, collect the same variables, and report them in the same efficient, automatic, manner.

Step four is investing in the infrastructure we need to make all this work—and sharing resources where that makes sense. If health authorities need an app to scan barcodes to track shipments, it doesn’t make sense for every province and territory to be using a different app. If we need to buy barcode scanners, every province should be buying the same one. Where it makes sense to share servers, we should share servers.

Step five is the easiest: Keep things current. It’s hard to think of any other instance where relying on 20-year-old technology standards makes sense. We need to be constantly revising and updating how we handle infectious diseases—the benefits will be apparent, in how we tackle everything from mumps, to HIV, to the next highly infectious disease that reaches our shores.

Again, these things are very doable, and don’t require any government to sacrifice autonomy. And, best yet, it can save us money.

On barcoding alone, a government panel estimated in 2009 that Canada would see $1 billion in savings by saving time, preventing wastage and reducing errors. On virtually every other front: Struggling through antiquated IT, and relying on overworked health staff to make up the difference, is expensive.

Governments don’t have to do it alone, either. Private industry can help.

In Alberta, start-up Okaki devised a simple, scalable system that can manage vaccination campaigns and even scan vaccine barcodes. The company has been running immunization drives for years, mostly in First Nations, and feeds its data directly into the provincial system—it is also compatible with Panorama.

CANImmunize, which began as an app allowing individuals to track their own vaccination record, now does many of the things Canada’s national system was supposed to do—including tracking appointments, monitoring adverse reactions, scanning vaccine barcodes. The technology can be fully integrated with Panorama.

Since I began writing about this issue for the Globe and Mail, my inbox has been inundated with emails from companies insisting that they could fix these problems in no time at all. There is no shortage of qualified people looking to help, and to innovate.

A group of companies, led by IBM, recently won a contract to build Germany’s vaccine passport system. It will use blockchain technology to make citizens’ vaccination records accessible, secure and verifiable. If we don’t get our act together soon, Canadians will be lucky to even get laminated paper vaccination records.

The provinces and territories need to come to the table and do this together. Our self-injurious commitment to federalism at all costs is endangering our own citizens. Because every province plays in their own needlessly walled garden, they are less prepared to deal with epidemics, they are less efficient at administering vaccines, and their citizens are more at risk from getting sick and dying.

Our country is supposed to be one of cooperative federalism, where provinces and territories can pursue creative solutions to unique problems. But when it comes to the basic mechanics of infectious disease outbreaks, there is no central leadership.

COVID-19 does not change shape when it crosses from Manitoba to Nunavut. We need the same set of tools in every province, or else we’re never going to fully beat this virus—and we’re going to be dangerously ill-equipped for the next one.

Source: Canada’s public health data meltdown

Filed under Government Tagged with COVID-19, health data, Justin Ling

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