Diversity isn’t a zero-sum game

2020/11/27 3 Comments

Useful look at the linkages between official languages and employment equity, indicating little conflict between two complementary goals. Given that TBS now provides breakdowns by individual groups, further analysis of OL and diversity by group would be helpful given the differences between groups (see my What new disaggregated data tells us about federal public service … and What the Public Service Employee Survey breakdowns of visible minority and other groups tell us about diversity and inclusion).

Little new, however, on the various suggestions to further improve diversity:

Fostering Canada’s rich diversity continues to be a national priority, as emphasized in the latest speech from the throne. Yet, critics often view diversity as a zero-sum game. One recent argument insisted that promoting French-language diversity and racial diversity represents “deeply contradictory goals with little introspection,” claiming that French-language requirements discriminate against racialized people. This trade-off mentality is dangerous because it pits groups against each other. In reality, French-language diversity and racial diversity can thrive in tandem, and the federal workforce is a living example of that.

French-language diversity is increasing

French-language diversity in Canada has always faced challenges but it first gained legal representation in 1969 through the Official Languages Act. Today, its preservation is reinforced by the Liberal Party modelling bilingualism in its speeches and investing a record $2.7 billion over five years starting in 2018–2019 to make bilingualism more accessible to Canadians. Additionally, non-partisan government policies, such as the Directive on Official Languages for People Management,have promoted bilingualism in the federal workplace.

Such political and administrative dynamics have helped bolster the number of government positions requiring bilingualism or French-only from 40.1 per cent in 2017 to 45.1 per cent in 2019, according to the latest data from the Treasury Board of Canada Secretariat. Interestingly, this same data set reveals a story of diversity complementarity rather than contradiction.

Racial diversity is also increasing

Two common ways of measuring diversity are (1) overall representation and (2) access to executive positions. For visible minorities (the government’s term for racialized people), both metrics have increased. Between 2017 and 2019, the number of government-employed visible minorities skyrocketed by 21.2 per cent, expanding their representation in the federal workforce from 15.1 per cent to 16.7 per cent (figure 1). Notably, Black representation increased the most, growing from 2.8 per cent to 3.2 per cent, and it did so without cannibalizing the representation of other visible minority groups (South Asian/East Indian, people of mixed origin, Chinese, and others).

Clearly, representation has improved but what about access to executive positions wielding power over decisions and resources? It has also improved. Between 2017 and 2019, the number of visible minority executives increased by 20.8 per cent, elevating their share of total executive positions from 10.2 per cent to 11.1 per cent. Again, there wasn’t any cannibalization across visible minority groups. However, this gain has been outpaced by the growth in visible minorities’ overall representation. What this means more broadly is that the pipeline of diverse candidates to fill the nation’s top bureaucratic positions has expanded quickly. Yet, more efforts to train, promote and retain these staff are required to ensure that senior leadership is more racially representative.

Promoting diversity can be inclusive

This complementary diversity is even clearer when French-language and racial data are combined. Since 2017, the federal government has added roughly 8,900 positions that require bilingualism or French-only speakers. Visible minorities have filled a whopping 28 per cent of these positions (which is almost double the percentage of working-age visible minorities in Canada who can speak French). This, in large part, is a result of greater access to language training and new initiatives to achieve departmental racial diversity goals. Simply put, visible minorities are fully capable of promoting the French language if they’re equipped with the proper resources.

Interestingly, these encouraging trends haven’t threatened many other diversity groups. For example, women’s representation and the share of Indigenous executives have both increased over the same period. This may be due to workers having intersectional identities. However, the myriad of diversity personified by top cabinet ministers signals the priority to reflect Canada’s true diversity in the government. Equally, the bureaucracy’s increasing emphasis on diversity since 2016 – through new studies, task forces, departmental diversity and inclusion councils, executive leadership development programs, and the like – has expanded diversity across multiple fronts.

A path forward for French-language diversity

French-language diversity and racial diversity in the Canadian government are increasing but more must be done to reflect Canada’s true diversity. To increase French-language diversity, the government should prioritize improving the quality of language training. Currently, departments use third-party language-training suppliers, which often entails high costs, as noted by the Treasury Board of Canada Secretariat. This decentralization across departments translates into a lack of standardization, inhibiting a high and consistent quality of education, and limited coordination, preventing departments from pooling resources and sharing best practices to teach French.

Instead, the government should offer more virtual group language lessons, workshops and resources through the Canada School of Public Service (the government’s central employee training hub). In-housing more teaching ensures greater quality control, broadens accessibility to more staff and saves on training costs in the long run. To help employees master French, the government should create short and immersive language-exchange programs – across departments and with international agencies – so that staff can work in a different official-language setting. These micro-assignments can include a language-mentoring component, which has also been suggested by the Privy Council Office. In turn, departments would benefit from these staff subsequently spurring more ideas, best practices and collaborations across departments and institutions.

A path forward for racial diversity

To increase racial representation, the government should invest in targeted recruiting programs. As the federal Joint Union/Management Task Force on Diversity and Inclusion suggests, recruiting racialized students has historically been challenging. Programs like the Indigenous Student Employment Opportunity and the Federal Internship Program for Canadians with Disabilitieselevate the importance of specific groups; a similar resource-backed program for racialized people would highlight them in recruitment. Another way to build the diversity pipeline is through sponsorship programs. In the United States, the Charles B. Rangel Graduate Fellowship Program(funded by the federal government) helps historically underrepresented U.S. minorities fund their graduate program, pairs them with mentors and places them in a full-time position at the U.S. State Department. This end-to-end program incubates talent from the start and fosters their long-term success with resources.

To boost racialized employees’ access to executive positions, the government should formalize a career mentorship program available across all departments. This government-wide approach would enable more standardization (while allowing for some departmental customization) and best-practice sharing. Additionally, departments should consider a reverse-mentorship program, whereby junior racialized staff act as mentors to senior non-racialized executives. Research and the United Kingdom Civil Service’s first-hand experiences reveal that such a program elevates a group’s visibility, unlocks more trust between groups and ultimately increases retention. These interactions also create a non-hierarchical feedback loop that enables executives to better understand lived realities and how the organizational culture interacts with those realities. Thus, they can more effectively address diversity and inclusion barriers.

Whether it’s targeted recruiting or mentorship programs, what’s crucial is that these initiatives be incremental to existing efforts and not cannibalize them. Additionally, accountability is integral to their success. For instance, this could mean factoring into executive evaluation and compensation how an organization performs based on its original diversity goals.

Diversity is just one piece of the journey

Canada’s commitments to cherish its French-language diversity and racial diversity deserve some praise. The federal workforce proves how these two can be complementary rather than a zero-sum trade-off. However, the Canadian government can’t rely on this positive trajectory because it’s far from being truly diverse and inclusive. That’s why it should standardize more official language teaching and bring it in-house, promote official language-exchange programs, invest in targeted recruiting for racialized people and institutionalize mentorship programs.

Beyond diversity, workplace inclusion equally needs attention. For example, the 2019 Public Service Employee Survey results show that visible minorities in the government are nearly twice as likely as non-visible minorities to report experiencing discrimination. This can negatively impact an individual’s sense of belonging, trust in a department, willingness to fully contribute at work and even retention.

Be it diversity challenges or inclusion challenges, resolving both is critical to reducing workplace inequities and socioeconomic disparities. Doing so is a necessary step to making diversity, inclusion and equity a reality in the Canadian government.

Source: Diversity isn’t a zero-sum game

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Boswell: Ten suggestions to help avoid a Trump-like nightmare in Canada

2020/11/10 1 Comment

A range of possible measures, some which focus on political culture, others require institutional change, and some more realistic than others. But a good list to discuss and debate (respectfully of course!):

While the CNN hosts expressed shock and disgust, other networks turned their cameras away and Late Show host Stephen Colbert choked back tears, I felt a deep satisfaction when U.S. President Donald Trump spoke directly to the American people (and the world) on Thursday night and launched a scorched-earth attack on his own country’s democratic process — declaring it corrupt and fraudulent because it was failing to recognize his unmatched greatness and divine claim to renewed power.

Had Trump shown an ounce of decency or graciousness in that moment, there might have been an inclination among his Republican allies, certain political observers and even some historians to frame their final judgment of the worst president in U.S. history more forgivingly.

Instead, no one should be able summarize the term in office of the 45th U.S. president as anything but a nightmare, its end — or at least the beginning of its end — suitably incoherent, desperate and terrifying.

But the Trump horror show of the past four years isn’t something Canadians should too swiftly forget. There are many lessons to be learned from what our neighbours to the south have been enduring since 2016 — though this country and the entire world has suffered along with them.

The following is a shortlist of 10 things we Canadians need to be thinking about in charting our own political future in a way that should prevent Trumpism from ever triumphing here.

• We need greater vigilance in calling out and condemning dog-whistling bigotry — not to mention undisguised bigotry — and other strategically divisive speech and actions among fringe political forces and mainstream actors alike;

• We need to demand basic decency in our political discourse and punish corrosive, hyper-partisan rhetoric in which legitimate opponents and other important players in public affairs (such as journalists) are characterized as enemies;

• We must establish a fully trusted electoral system in which the efficiency, transparency, fairness and integrity of the voting process is guaranteed with adequate funding and the best technology and organizational protocols;

• We should move toward an electoral system in which citizens’ voting preferences are more fairly reflected in the composition of our legislative bodies, and where majority power cannot be obtained without majority support at the polls;

• We must extend and expedite efforts to identify, condemn and curb transparently false, incendiary, conspiratorial communication in all digital and other forms;

• We should foster a political culture in which arguments are routinely scrutinized to ensure evidence-based, science-backed, logical thinking prevails over groundless assertions, no matter how colourfully or passionately expressed;

• We must promote greater ethnocultural diversity and gender equity at all levels of our representative democracy to ensure decision-making bodies, the public service and public discourse better reflect the true complexion of our ever-evolving population;

• We have to redouble efforts to improve all Canadians’ understanding of what responsible citizenship requires in a participatory democracy, recognizing the importance of both free speech and tolerance, media literacy, and basic knowledge of civics, history, geography, math and science;

• We need to recognize that achieving and maintaining a stable, constructive democratic culture in this country requires a high degree of social cohesion, political unity and mutual support across the federation’s provincial and territorial jurisdictions;

• We also need to understand that safeguarding democratic cultures in any country requires a sustained, collective commitment to promoting similar values internationally through strong, multilateral, global institutions.

It goes without saying that this really is just a shortlist. Canadians need to do much more to prevent the rise of a demagogue here.

We need to treat the Earth sustainably, we need to respect each other’s human rights and the rule of law, and we need to strive to promote social and economic justice — as well as social and economic freedom — while creating and recreating a healthy political culture.

But in those maddening, pathetic, horrifying moments at the White House presidential podium on Thursday night, Canadians were given a parting gift by Trump the Terrible: an enduring reminder that we can’t ever let politics in this country descend to such dark and dangerous depths.

Randy Boswell is a journalist and Carleton University professor.

Source: https://ottawacitizen.com/opinion/boswell-ten-suggestions-to-help-avoid-a-trump-like-nightmare-in-canada

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After Months of Minimal COVID-19 Containment, Sweden Appears to Be Considering a New Approach

2020/10/21 Leave a comment

 

Better late than never:

Swedish authorities appear to be reconsidering their notoriously lax approach to COVID-19 containment, which has contributed to one of the world’s higher coronavirus death rates.

Starting Oct. 19, regional health authorities may direct citizens to avoid high-risk areas such as gyms, concerts, public transportation and shopping centers, the Telegraph reports. They may also encourage residents to avoid socializing with elderly or other high-risk individuals.

“It’s more of a lockdown situation—but a local lockdown,” Dr. Johan Nojd, who leads the infectious diseases department in the city of Uppsala, told theTelegraph.

In a statement provided to TIME, however, a spokesperson for the Public Health Agency of Sweden rejected that characterization.

“It is not a lockdown but some extra recommendations that could be communicated locally when a need from the regional authorities is communicated and the Public Health Agency so decides,” the spokesperson said.

A legal official from Sweden’s public health agency told the Telegraph the new policy is “something in between regulations and recommendations.” Violating the guidelines, for example, would not result in fines. Still, it’s a significant shift from Sweden’s previous handling of the coronavirus pandemic. While countries around the world implemented lockdowns once the virus began spreading, Swedish authorities largely let life continue as normal.

The Swedish government in March limited public gatherings to 50 people, but the policy left gaping loopholes—it doesn’t apply to private and corporate gatherings, nor to schools, shopping malls and plenty of other locations. Restaurants and bars never closed. Masks are not recommended in most places. There’s little to stop people from going to school or work if they come into contact with an infected person. Sweden’s testing and contact tracing capacitiesare lacking.

As of Oct. 18, Sweden’s per-capita death rate—58.6 per 100,000 people—was among the highest in the world. And from early September to early October, average daily cases nationwide rose by 173%, with particularly dramatic increases in cities such as Stockholm and Uppsala.

These hard-hit areas are the focus of Sweden’s shifting guidance, according to theTelegraph‘s report. Nojd told the outlet he is considering telling people in Uppsala not to visit the elderly and other vulnerable populations, and to avoid making unnecessary trips on public transportation. He also mentioned the possibility of imposing curfews on restaurants.

Representatives from the city of Uppsala did not immediately respond to TIME’s request for further comment.

Swedish authorities appear to be conceding that reaching herd immunity—the threshold at which enough of a population is immune to the virus for it to stop spreading widely—is unlikely to be happen without a vaccine. While officials have avoided explicitly calling herd immunity the goal of their casual containment approach, emails obtained by journalists show high-level Swedish public-health officials discussing that strategy as early as March, apparently motivated by economic concerns.

National studies, however, show that far fewer people have developed natural immunity than officials hoped—as evidenced by the ongoing spike in infections. Sweden’s state epidemiologist Anders Tegnell acknowledged that reality last week.

“I think the obvious conclusion is that the level of immunity in those cities is not at all as high as we have, as maybe some people, have believed,” Tegnell said. “I think what we are seeing is very much a consequence of the very heterogeneous spread that this disease has, which means that even if you feel like there have been a lot of cases in some big cities, there are still huge pockets of people who have not been affected yet.”

Source: After Months of Minimal COVID-19 Containment, Sweden Appears to Be Considering a New Approach

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The Second Wave: Science Meets Leadership

2020/10/17 Leave a comment

Good nuanced discussion of the complexities in finding a balance between public health, economic and other concerns:

When the pandemic first hit, none of us knew what to expect. Medical experts called for a lockdown and governments took their advice. This time round it’s different. Our political leaders are being called on to protect both our health and our economy. As Doug Ford noted on Tuesday, that can be an unpleasant place to be.

In his press conference, Ford commented on his decision to reinstate Stage 2 measures in three key regions of Ontario, much as François Legault has done in Quebec. It was, he says, one of the hardest decisions of his career. We get it but, frankly, he should get used to it. Governments everywhere may be called on to make lots more decisions like this in the months ahead.

Businesses are hurting badly, and many are stepping up the pressure on politicians to help them get through these tough times. This is not just about financial support. In Ottawa, for example, business groups have challenged Ford to produce the data that justifies stricter measures. There is a growing sense that politicians have the tools to open the economy without putting the public at risk, but do they?

We think this is a discussion worth having – cautiously and respectfully. We’re not disputing that public health is the No 1 priority. The hard question is whether it can be better aligned with other priorities. A recent poll from the Innovative Research Group helps us get at the issue:

The response to Question 1 caught our attention. It shows that Canadians are almost evenly split on whether they think experts have too much influence on governments. This sheds important light on the tensions Ford is dealing with, and why other premiers will likely face the same issues, as the second wave grows. Some, such as Legault, already are.

Basically, during the first wave, political leaders deferred to public health officials on how to respond to the pandemic. This served us well, but governments have come a long way over the last eight months. New knowledge and new tools like rapid testing and contact tracing now allow leaders to manage the risks in ways that were not possible before.

For example, experts now know enough about how the virus spreads to contain it within a region, so that governments don’t have to shut down a whole province. This is currently the approach in Ontario and Quebec.

However, there is a price to pay for plans like this. Generally, the more complex they get, the less likely they are to be guided by medical science. In Ontario, for example, the government’s decision to shut down bars, restaurants, and gyms while leaving schools open has raised eyebrows.

There are serious questions about how far the science on COVID-19 can help decision-makers assess the importance of getting children back to school. Striking a balance between public health risks and learning involves weighing lots of things that are outside the purview of medical science.

So, how are these tradeoffs getting made?

In a second slide, IRG reveals an important feature of our political culture. The slide uses a scale of 1 – 100 to assess how strongly Liberals, Conservatives, and NDP members feel about the role of experts in government decision-making. The poll finds a 24-point spread between Liberals and Conservatives, with the NDP in the middle. (See the line on Political Populism.)

Basically, the data show that our political leaders are predisposed to treat expert opinion differently: progressives are more inclined to accept it and conservatives to question it.

Neither predisposition is wrong, but predispositions of any kind can be a barrier to a thoughtful, informed discussion of the issues. They incline us to trust some views more than others and this can shape how we think and talk about the issues.

This is a critical consideration as the second wave advances. When health experts declare that “the evidence” calls for actions that favour health over, say, the economy, political leaders need a reliable way to weigh this advice against other concerns and priorities. And they shouldn’t look to health experts to provide it.

Health experts view the world through a health lens. Their role doesn’t train them to consider how this affects other priorities, such as the economy or learning. That is what elected officials are supposed to do – but they need a reliable way of thinking through the issues.

As things stand, the poll suggests that these decisions often come down to a leader’s predispositions – whether they are a conservative or a progressive. We don’t think that’s not good enough.

Increasingly, our governments are being called on to respond to all aspects of the pandemic, not just public health. Predisposition are not a reliable guide to this. They will not disappear, but we can be conscious of them and keep them in check.

Different priorities should be publicly discussed and balanced against public health. To be clear, we are NOT disputing that public health is the No 1 priority, but we do believe that governments need the flexibility to experiment with different options and to respond to other priorities.

That is the way forward.

Andrew Balfour is Managing Partner at Rubicon Strategy in Ottawa.

Source: The Second Wave: Science Meets Leadership

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The Swedish COVID-19 Response Is a Disaster. It Shouldn’t Be a Model for the Rest of the World

2020/10/16 Leave a comment

Good telling analysis. By way of comparison, Quebec death rate is about 71 per 100,000, Ontario 21 per 100,000 and Canada less Quebec 13 per 100,000.

Money quote: “The Swedish way has yielded little but death and misery.”

The Swedish COVID-19 experiment of not implementing early and strong measures to safeguard the population has been hotly debated around the world, but at this point we can predict it is almost certain to result in a net failure in terms of death and suffering. As of Oct. 13, Sweden’s per capita death rate is 58.4 per 100,000 people, according to Johns Hopkins University data, 12th highest in the world (not including tiny Andorra and San Marino). But perhaps more striking are the findings of a study published Oct. 12 in the Journal of the American Medical Association, which pointed out that, of the countries the researchers investigated, Sweden and the U.S. essentially make up a category of two: they are the only countries with high overall mortality rates that have failed to rapidly reduce those numbers as the pandemic has progressed.

Yet the architects of the Swedish plan are selling it as a success to the rest of the world. And officials in other countries, including at the top level of the U.S. government, are discussing the strategy as one to emulate—despite the reality that doing so will almost certainly increase the rates of death and misery.

Countries that locked down early and/or used extensive test and tracing—including Denmark, Finland, Norway, South Korea, Japan, Taiwan, Vietnam and New Zealand—saved lives and limited damage to their economies. Countries that locked down late, came out of lock down too early, did not effectively test and quarantine, or only used a partial lockdown—including Brazil, Mexico, Netherlands, Peru, Spain, Sweden, the U.S. and the U.K.—have almost uniformly done worse in rates of infection and death.

Despite this, Sweden’s Public Health Agency director Johan Carlson has claimedthat “the Swedish situation remains favorable,” and that the country’s response has been “consistent and sustainable.” The data, however, show that the case rate in Sweden, as elsewhere in Europe, is currently increasing.

Average daily cases rose 173% nationwide from Sept. 2-8 to Sept. 30-Oct. 6 and in Stockholm that number increased 405% for the same period. Though some have argued that rising case numbers can be attributed to increased testing, a recent study of Stockholm’s wastewater published Oct. 5 by the Swedish Royal Institute of Technology (KTH) argues otherwise. An increased concentration of the virus in wastewater, the KTH researchers write, shows a rise of the virus in the population of the greater Stockholm area (where a large proportion of the country’s population live) in a way that is entirely independent of testing. Yet even with this rise in cases, the government is easing the few restrictions it had in place.

From early on, the Swedish government seemed to treat it as a foregone conclusion that many people would die. The country’s Prime Minister Stefan Löfven told the Swedish newspaper Dagens Nyheter on April 3, “We will have to count the dead in thousands. It is just as well that we prepare for it.” In July, as the death count reached 5,500, Löfven said that the “strategy is right, I am completely convinced of that.” In September, Dr. Anders Tegnell, the Public Health Agency epidemiologist in charge of the country’s COVID-19 response reiterated the party line that a growing death count did “not mean that the strategy itself has gone wrong.” There has been a lack of written communication between the Prime Minister and the Pubic Health Authority: when the authors requested all emails and documents between the Prime Minister’s office and the Public Health Authority for the period Jan. 1—Sept. 14, the Prime Minister’s Registrar replied on Sept. 17 that none existed.

Despite the Public Health Agency’s insistence to the contrary, the core of this strategy is widely understood to have been about building natural “herd immunity”—essentially, letting enough members of a population (the herd) get infected, recover, and then develop an immune system response to the virus that it would ultimately stop spreading. Both the agency and Prime Minister Löfven have characterized the approach as “common sense“ trust-based recommendations rather than strict measures, such as lockdowns, which they say are unsustainable over an extended period of time—and that herd immunity was just a desirable side effect. However, internal government communications suggest otherwise.

Emails obtained by one of the authors through Freedom of Information laws (called offentlighetsprincipen, or “Openness Principle,” in Swedish) between national and regional government agencies, including the Swedish Public Health Authority, as well as those obtained by other journalists, suggest that the goal was all along in fact to develop herd immunity. We have also received information through sources who made similar requests or who corresponded directly with government agencies that back up this conclusion. For the sake of transparency, we created a website where we’ve posted some of these documents.

One example showing clearly that government officials had been thinking about herd immunity from early on is a March 15 email sent from a retired doctor to Tegnell, the epidemiologist and architect of the Swedish plan, which he forwarded to his Finnish counterpart, Mika Salminen. In it, the retired doctor recommended allowing healthy people to be infected in controlled settings as a way to fight the epidemic. “One point would be to keep schools open to reach herd immunity faster,” Tegnell noted at the top of the forwarded email.

Salminen responded that the Finnish Health Agency had considered this but decided against it, because “over time, the children are still going to spread the infection to other age groups.” Furthermore, the Finnish model showed that closing schools would reduce “the attack rate of the disease on the elderly” by 10%. Tegnell responded: “10 percent might be worth it?”

The majority of the rest of Sweden’s policymakers seemed to have agreed: the country never closed daycare or schools for children under the age of 16, and school attendance is mandatory under Swedish law, with no option for distance learning or home schooling, even for family members in high risk groups. Policymakers essentially decided to use children and schools as participants in an experiment to see if herd immunity to a deadly disease could be reached. Multiple outbreaks at schools occurred in both the spring and autumn.

At this point, whether herd immunity was the “goal” or a “byproduct” of the Swedish plan is semantics, because it simply hasn’t worked. In April, the Public Health Agency predicted that 40% of the Stockholm population would have the disease and acquire protective antibodies by May. According to the agency’s ownantibody studies published Sept. 3 for samples collected up until late June, the actual figure for random testing of antibodies is only 11.4% for Stockholm, 6.3% for Gothenburg and 7.1% across Sweden. As of mid-August, herd immunity was still “nowhere in sight,” according to a Journal of the Royal Society of Medicinestudy. That shouldn’t have been a surprise. After all, herd immunity to an infectious disease has never been achieved without a vaccine.

Löfven, his government, and the Public Health Agency all say that the high COVID-19 death rate in Sweden can be attributed to the fact that a large portion of these deaths occurred in nursing homes, due to shortcomings in elderly care.

However, the high infection rate across the country was the underlying factor that led to a high number of those becoming infected in care homes. Many sick elderly were not seen by a doctor because the country’s hospitals were implementing a triage system that, according to a study published July 1 in the journal Clinical Infectious Diseases, appeared to have factored in age and predicted prognosis. “This likely reduced [intensive care unit] load at the cost of more high-risk patients”—like elderly people with confirmed infection—dying outside the ICU.” Only 13% of the elderly residents who died with COVID-19 during the spring received hospital care, according to preliminary statistics from the National Board of Health and Welfare released Aug.

In one case which seems representative of how seniors were treated, patient Reza Sedghi was not seen by a doctor the day he died from COVID-19 at a care home in Stockholm. A nurse told Sedghi’s daughter Lili Perspolisi that her father was given a shot of morphine before he passed away, that no oxygen was administered and staff did not call an ambulance. “No one was there and he died alone,” Perspolisi says.

In order to be admitted for hospital care, patients needed to have breathing problems and even then, many were reportedly denied care. Regional healthcare managers in each of Sweden’s 21 regions, who are responsible for care at hospitals as well as implementing Public Health Agency guidelines, have claimed that no patients were denied care during the pandemic. But internal local government documents from April from some of Sweden’s regions—including those covering the biggest cities of Stockholm, Gothenburg and Malmö—also show directives for how some patients including those receiving home care, those living at nursing homes and assisted living facilities, and those with special needs could not receive oxygen or hospitalization in some situations. Dagens Nyheterpublished an investigation on Oct. 13 showing that patients in Stockholm were denied care as a result of these guidelines. Further, a September investigation by Sveriges Radio, Sweden’s national public broadcaster, found that more than 100 people reported to the Swedish Health and Care Inspectorate that their relatives with COVID-19 either did not receive oxygen or nutrient drops or that they were not allowed to come to hospital.

These issues do not only affect the elderly or those who had COVID-19. The National Board of Health and Welfare’s guidelines for intensive care in extraordinary circumstances throughout Sweden state that priority should be given to patients based on biological, not chronological, age. Sörmlands Media, in an investigation published May 13, cited a number of sources saying that, in many parts of the country, the health care system was already operating in a way such that people were being denied the type of inpatient care they would have received in normal times. Regional health agencies were using a Clinical Frailty Scale, an assessment tool designed to predict the need for care in a nursing home or hospital, and the life expectancy of older people by estimating their fragility, to determine whether someone should receive hospital care and was applied to decisions regarding all sorts of treatment, not only for COVID-19. These guidelines led to many people with health care needs unrelated to COVID-19 not getting the care they need, with some even dying as a result—collateral damage of Sweden’s COVID-19 strategy.

Dr. Michael Broomé, the chief physician at Stockholm’s Karolinska Hospital’s Intensive Care Unit, says his department’s patient load tripled during the spring. His staff, he says, “have often felt powerless and inadequate. We have lost several young, previously healthy, patients with particularly serious disease courses. We have also repeatedly been forced to say no to patients we would normally have accepted due to a lack of experienced staff, suitable facilities and equipment.”

In June, Dagens Nyheter reported a story of one case showing how disastrous such a scenario can be. Yanina Lucero had been ill for several weeks in March with severe breathing problems, fever and diarrhea, yet COVID-19 tests were not available at the time except for those returning from high risk areas who displayed symptoms, those admitted to the hospital, and those working in health care. Yanina was only 39 years old and had no underlying illnesses. Her husband Cristian brought her to an unnamed hospital in Stockholm, but were told it was full and sent home, where Lucero’s health deteriorated. After several days when she could barely walk, an ambulance arrived and Lucero was taken to Huddinge hospital, where she was sedated and put on a ventilator. She died on April 15 without receiving a COVID-19 test in hospital.

Sweden did try some things to protect citizens from the pandemic. On March 12 the government restricted public gatherings to 500 people and the next day the Public Health Agency issued a press release telling people with possible COVID-19 symptoms to stay home. On March 17, the Public Health Agency asked employers in the Stockholm area to let employees work from home if they could. The government further limited public gatherings to 50 people on March 29. Yet there were no recommendations on private events and the 50-person limit doesn’t apply to schools, libraries, corporate events, swimming pools, shopping malls or many other situations. Starting April 1, the government restricted visitsto retirement homes (which reopened to visitors on Oct. 1 without masksrecommended for visitors or staff). But all these recommendations came later than in the other Nordic countries. In the interim, institutions were forced to make their own decisions; some high schools and universities changed to on-line teaching and restaurants and bars went to table seating with distance, and some companies instituted rules about wearing masks on site and encouraging employees to work from home.

Meanwhile Sweden built neither the testing nor the contact-tracing capacity that other wealthy European countries did. Until the end of May (and again in August), Sweden tested 20% the number of people per capita compared with Denmark, and less than both Norway and Finland; Sweden has often had among the lowest test rates in Europe. Even with increased testing in the fall, Sweden still only tests only about one-fourth that of Denmark.

Sweden never quarantined those arriving from high-risk areas abroad nor did it close most businesses, including restaurants and bars. Family members of those who test positive for COVID-19 must attend school in person, unlike in many other countries where if one person in a household tests positive the entire family quarantines, usually for 14 days. Employees must also report to work as usual unless they also have symptoms of COVID-19, an agreement with their employer for a leave of absence or a doctor recommends that they isolate at home.

On Oct. 1, the Public Health Authority issued non-binding “rules of conduct” that open the possibility for doctors to be able to recommend that certain individuals stay home for seven days if a household member tests positive for COVID-19. But there are major holes in these rules: they do not apply to children (of all ages, from birth to age 16, the year one starts high school), people in the household who previously have a positive PCR or antibody test or, people with socially important professions, such as health care staff (under certain circumstances).

There is also no date for when the rule would go into effect. “It may not happen right away, Stockholm will start quickly but some regions may need more time to get it all in place,” Tegnell said at a Oct. 1 press conference. Meanwhile, according to current Public Health Agency guidelines issued May 15 and still in place, those who test positive for COVID-19 are expected to attend work and school with mild symptoms so long as they are seven days post-onset of symptoms and fever free for 48 hours.

Sweden actually recommends against masks everywhere except in places where health care workers are treating COVID-19 patients (some regions expand that to health care workers treating suspected patients as well). Autumn corona outbreaks in Dalarna, Jönköping, Luleå, Malmö, Stockholm and Uppsalahospitals are affecting both hospital staff and patients. In an email on April 5, Tegnell wrote to Mike Catchpole, the chief scientist at the European Center for Disease Control and Prevention (ECDC): “We are quite worried about the statement ECDC has been preparing about masks.” Tegnell attached a documentin which he expresses concern that ECDC recommending facemasks would “imply that the spread is airborne which would seriously harm further communication and trust among the population and health care workers” and concludes “we would like to warn against the publication of this advice.” Despite this, on April 8 ECDC recommended masks and on June 8 the World Health Organization updated its stance to recommend masks.

Sweden’s government officials stuck to their party line. Karin Tegmark Wisell of the Public Health Agency said at a press conference on July 14 that “we see around the world that masks are used in a way so that you rather increase the spread of infection.” Two weeks later, Lena Hallengren, the Minister of Health and Social Affairs, spoke about masks at a press conference on July 29 and said, “We don’t have that tradition or culture” and that the government “would not review the Public Health Agency’s decision not to recommend masks.”

All of this creates a situation which leaves teachers, bus drivers, medical workers and care home staff more exposed, without face masks at a time when the rest of the world is clearly endorsing widespread mask wearing.

On Aug. 13, Tegnell said that to recommend masks to the public “quite a lot of resources are required. There is quite a lot of money that would be spent if you are going to have masks.” Indeed, emails between Tegnell and colleagues at the Public Health Agency and Andreas Johansson of the Ministry of Health and Social Affairs show that the policy concerns of the health authority were influenced by financial interests, including the commercial concerns of Sweden’s airports.

Swedavia, the owner of the country’s largest airport, Stockholm Arlanda, told employees during the spring and early summer they could not wear masks or gloves to work. One employee told Upsala Nya Tidning newspaper on Aug. 24 “Many of us were sick during the beginning of the pandemic and two colleagues have died due to the virus. I would estimate that 60%-80% of the staff at the security checks have had the infection.”

“Our union representatives fought for us to have masks at work,” the employee said, “but the airport’s response was that we were an authority that would not spread fear, but we would show that the virus was not so dangerous.” Swedavia’s reply was that they had introduced the infection control measures recommended by the authorities. On July 1, the company changed its policy, recommending masks for everyone who comes to Arlanda—that, according to a Swedavia spokesperson, was not as a result of “an infection control measure advocated by Swedish authorities,” but rather, due to a joint European Union Aviation Safety Agency and ECDC recommendation for all of Europe.

As early as January, the Public Health Agency was warning the government about costs. In a Jan. 31 communique, Public Health Agency Director Johan Carlsson (appointed by Löfven) and General Counsel Bitte Bråstad wrote to the Ministry of Health and Social Affairs, cautioning the government about costs associated with classifying COVID-19 as a socially dangerous disease: “After a decision on quarantine, costs for it [include] compensation which according to the Act, must be paid to those who, due to the quarantine decision, must refrain from gainful employment. The uncertainty factors are many even when calculating these costs. Society can also suffer a loss of production due to being quarantined [and] prevented from performing gainful employment which they would otherwise have performed.” Sweden never implemented quarantine in society, not even for those returning from travel abroad or family members of those who test positive for COVID-19.

Not only did these lack of measures likely result in more infections and deaths, but it didn’t even help the economy: Sweden has fared worse economically than other Nordic countries throughout the pandemic.

The Swedish way has yielded little but death and misery. And, this situation has not been honestly portrayed to the Swedish people or to the rest of the world.

A Public Health Agency report published July 7 included data for teachers in primary schools working on-site as well as for secondary school teachers who switched to distance instruction online. In the report, they combined the two data sources and compared the result to the general population, stating that teachers were not at greater risk and implying that schools were safe. But in fact, the infection rate of those teaching in classrooms was 60% higher than those teaching online—completely undermining the conclusion of the report.

The report also compares Sweden to Finland for March through the end of May and wrongly concludes that the ”closing of schools had no measurable effect on the number of cases of COVID-19 among children.” As testing among children in Sweden was almost non-existent at that time compared to Finland, these data were misrepresented; a better way to look at it would be to consider the fact that Sweden had seven times as many children per capita treated in the ICU during that time period.

When pressed about discrepancies in the report, Public Health Agency epidemiologist Jerker Jonsson replied on Aug. 21 via email: “The title is a bit misleading. It is not a direct comparison of the situation in Finland to the situation in Sweden. This is just a report and not a peer-reviewed scientific study. This was just a quick situation report and nothing more.” However the Public Health Agency and Minister of Education continue to reference this report as justification to keep schools open, and other countries cite it as an example.

This is not the only case where Swedish officials have misrepresented data in an effort to make the situation seem more under control than it really is. In April, a group of 22 scientists and physicians criticized Sweden’s government for the 105 deaths per day the country was seeing at the time, and Tegnell and the Public Health Agency responded by saying the true number was just 60 deaths per day. Revised government figures now show Tegnell was incorrect and the critics were right. The Public Health Agency says the discrepancy was due to a backlog in accounting for deaths, but they have backlogged deaths throughout the pandemic, making it difficult to track and gauge the actual death toll in real time.

Sweden never went into an official lockdown but an estimated 1.5 million have self-isolated, largely the elderly and those in risk groups. This was probably the largest factor in slowing the spread of the virus in the country in the summer. However, recent data suggest that cases are yet again spiking in the country, and there’s no indication that government policies will adapt.

Health care workers, scientists and private citizens have all voiced concerns about the Swedish approach. But Sweden is a small country, proud of its humanitarian image—so much so that we cannot seem to understand when we have violated it. There is simply no way to justify the magnitude of lost lives, poorer health and putting risk groups into long-term isolation, especially not in an effort to reach an unachievable herd immunity. Countries need to take care before adopting the “Swedish way.” It could have tragic consequences for this pandemic or the next.

Source: The Swedish COVID-19 Response Is a Disaster. It Shouldn’t Be a Model for the Rest of the World

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Ottawa was told about potential problems at Public Health Agency, top doctors say

2020/10/14 Leave a comment

This is a much bigger scandal than WE in terms of governance and expertise, reflecting in part the previous Conservative government’s disregard for science and expertise:

The federal government was warned years ago that the Public Health Agency of Canada was destined for serious problems unless changes were made to its oversight, but those concerns were ignored, two of Canada’s top doctors say.

A steady erosion of scientific capacity and a chronic shortage of resources over the past decade have left the agency unable to do its job properly, public-health experts Perry Kendall and Paul Gully told The Globe and Mail.

Recent problems, including the mishandling of the country’s pandemic early warning system, emergency stockpile shortages and allegations that scientists were forced to “dumb down” reports for senior government officials, are all symptoms of a larger ailment afflicting the agency, the doctors said.

“We are of the view that long-term deficiencies of expertise and funding prevent the Public Health Agency of Canada from fully carrying out its intended and necessary role,” Dr. Kendall said.

“A lot of the tools that the Public Health Agency had for influencing policy and programs were removed and budgets were cut.”

They are harsh words from two of Canada’s most respected public-health figures. Dr. Kendall preceded Bonnie Henry as B.C.’s provincial health officer from 1999 to 2018, and has been a leading voice in public-health policy. Dr. Gully spent 14 years in senior roles at Health Canada, and was also the country’s deputy chief public health officer from 2004 to 2006. He later worked on pandemic preparedness for the World Health Organization.

Both Dr. Kendall and Dr. Gully say many of today’s problems can be traced back to serious funding constraints that began in 2011, and a controversial 2015 decision to restructure the management hierarchy.

After the 2003 SARS crisis, the agency was created to act as an independent voice within government. But a move by the Harper government to install a president to run Public Health effectively reduced the Chief Public Health Officer (CPHO) to the role of an adviser, and left the department exposed to competing priorities and political influence.

Dr. Kendall warned during federal hearings five years ago that the change would weaken the agency in ways that were not readily apparent.

By taking oversight of programs and budgets away from the CPHO, whose job was to plan for a pandemic even in times of relative safety, and placing them in the hands of government appointees instead, the agency would be subject to inadequate planning, he warned in 2015. This was particularly risky during the years in between a crisis, Dr. Kendall argued, when resources could be reallocated without thought to the consequences.

That erosion is now on display during the COVID-19 crisis, Dr. Gully and Dr. Kendall said. They argue that current CPHO Dr. Theresa Tam and other public-health doctors have performed their roles well in the face of these constraints, but the agency itself was never intended to operate this way.

Public Health has been beset by numerous problems, including the silencing of the country’s once highly respected pandemic early warning system, known as the Global Public Health Intelligence Network. GPHIN was the focus of a Globe and Mail investigation in late July, which prompted the Auditor-General and the Health Minister to launch separate probes into the the matter.

Doctors and epidemiologists at Public Health told The Globe that the agency experienced an influx of senior government officials in recent years who lacked a sufficient understanding of science. That made it difficult to convey urgent and crucial information up the chain of command, and complex reports had to be oversimplified or “dumbed down.”

Soon after those concerns came to light, management at the agency was shuffled. Public Health president Tina Namiesniowski, who came to the job with no background in science, resigned suddenly last month and was replaced by the former head of the National Research Council, Iain Stewart.

“Certainly, my sense is that there’s been a loss of that scientific capacity,” Dr. Gully said, which impacts how Canada responds to a crisis such as COVID-19.

“If the scientific capacity of PHAC was such that the agency could rapidly analyze and give advice, in real time, on the numerous issues that require policy and political decisions, then the federal role would have been more effective,” Dr. Gully said.

The silencing of GPHIN, which was renowned for its ability to gather intelligence on past outbreaks to help speed government decision-making, is an example of the kinds of breakdowns Dr. Kendall warned could happen in his testimony five years ago. With no threat of a deadly outbreak in years, the department officials believed in 2019 that GPHIN’s analysts and resources could be put to better use on domestic projects that did not involve pandemic preparedness.

Dr. Kendall called that decision “short-sighted,” adding that the warning and surveillance system had once worked effectively. “In the past, as a prime source of intelligence, GPHIN would have been able to provide a more timely alert and analysis.”

However, the concerns are not limited to GPHIN, he said.

“Obviously, rebuilding the Global Public Health Intelligence Network capacity is important, and big data is on everybody’s lips, so maybe there’s some way of using big data to enhance [GPHIN],” he said.

Both Dr. Kendall and Dr. Gully believe the government should now revisit the structure of the Public Health Agency, including how it is funded.

“I would strongly support revisiting and reopening the Act and creating the Chief Public Health Officer as the head of the agency. And then having the necessary administrative and political support underneath,” Dr. Kendall said.

Their comments echo those of another respected public-health doctor, David Butler-Jones, the country’s first CPHO, who warned in February that Canada had, over the years, “replaced public-health managers and analysts with generic public servants.” He added: “Resources, expertise and capacity have been reduced, and expertise positioned further away from where organizational decisions are made.”

In creating the president’s role in early 2015, the government said it wanted to ease the CPHO’s administrative workload. However, the doctors don’t buy that argument, saying the change allowed for greater control over Public Health’s decisions and hindered its ability to handle a crisis.

“We sincerely hope that there is a comprehensive examination of federal public-health capacity,” Dr. Gully said. “And that Public Health will be adequately resourced and empowered to return to its former pre-eminence as a trusted source of independent advice, scientific knowledge, and national and global leadership.”

“That’s why we’re coming forward now – because it’s obvious now,” he said.

Source: https://www.theglobeandmail.com/canada/article-ottawa-was-told-about-potential-problems-at-public-health-agency-top/

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Ending Canada’s pandemic alert system was a mistake, internal government e-mails show

2020/10/07 Leave a comment

More details regarding this fail continue to emerge:

Internal government e-mails show at least one senior manager at the Public Health Agency of Canada believed the decision that caused the country’s pandemic early warning system to go silent last year was a mistake. In an e-mail sent to staff July 27 – two days after The Globe and Mail published an investigation into the Global Public Health Intelligence Network, or GPHIN – a senior department official acknowledged the shutdown shouldn’t have happened.

The investigation detailed how Canada’s globally respected pandemic alert system went silent in early 2019, after the department issued an edict requiring GPHIN’s doctors and epidemiologists to obtain “senior management” approval before they could warn of potentially deadly outbreaks.

That edict, which came as the department sought to reallocate GPHIN’s resources to other projects, effectively shut down one of its most critical functions. With no management approvals, the alert system went silent. And with it, much of the unit’s advance warning and intelligence gathering soon dried up – less than a year before the COVID-19 outbreak hit.

“I believe I can make the assumption that you’ve all noticed that The Globe did an article on GPHIN,” Christopher Burt, a senior manager at Public Health, told colleagues in the e-mail, which was obtained under Access to Information laws.

“You and I know the right answer was always to let the analysts issue alerts where they see fit.”

It is a surprising admission, providing a glimpse into the mindset of a department that has largely kept quiet about the GPHIN problems. It suggests that different layers of managers disagreed over the decisions that would ultimately hinder Canada’s pandemic warning and intelligence gathering.

In a statement this summer, the government initially denied the system had stopped working. However, The Globe obtained 10 years of internal GPHIN records that showed the alert system suddenly ceased operating on May 24, 2019, as a result of the decision.

After the edict was made, some of the analysts inside the highly specialized unit – whose job was to detect and monitor dangerous outbreaks around the world and issue warnings of potential threats – were reassigned to other work that didn’t involve pandemic preparedness. With no threats of a pandemic for years, the analysts were moved to domestic projects deemed more valuable to the government, such as studying the effects of vaping in Canada.

However, GPHIN’s role in pandemic preparedness is now being reassessed. Canada’s Auditor-General is investigating the matter and, last month, Health Minister Patty Hajdu ordered an independent federal review into the department’s oversight of GPHIN.

“The conversation around alerts is still a schmozzle,” Mr. Burt told staff in the July 27 e-mail. “That this conversation is even occurring is further proof that GPHIN remains an important and valuable tool – respected in Canada and around the world.”

Referencing The Globe’s investigation, Mr. Burt said, “It’s clear the reporter had a number of sources, all of whom seem to have painted a rather stark picture. Democracy is messy sometimes.”

He added. “From a policy effectiveness standpoint, all news is good news. Although the tone of the article is negative, I believe that the effect for GPHIN will ultimately be a positive one.”

Created in the mid-1990s when Canada realized it needed better advance warning of potentially dangerous global outbreaks, GPHIN’s role was to act as a sort of smoke detector inside the government, sounding alarms early and often – not merely when problems were initially detected, but also as they worsened. The idea was to inject urgency into government decisions by gathering intelligence on situations, so that officials could assess the threat early and take quick action to protect the country.

As an intelligence unit, GPHIN was also intended to help inform Canada’s risk assessments on a potential crisis.

The government has faced criticism over the accuracy of its official risk assessments. For much of January, February and March, Canada’s official position on the outbreak was that the novel coronavirus posed a “low” threat to the country, despite evidence the virus was spreading aggressively and that human-to-human transmission was a reality. Even after the World Health Organization changed its rating to “high” at the end of January, and warned countries to begin preparing, Canada maintained that low rating for another seven weeks.

Several Public Health employees, who The Globe is not naming because they are not authorized to speak publicly, have said the government preferred to rely on “official” information provided by the Chinese government and the WHO, and dismissed intelligence gathering as “rumours.”

Intelligence experts say this was a critical mistake, particularly since countries have been known to hide or play down outbreaks in the past.

“It’s invaluable to have a separate monitoring source so that you can know everything that’s possible to know about the course of the disease and what the country of origin, or city, knows about it,” said Greg Fyffe, the former executive director of the government’s Intelligence Assessment Secretariat from 2000 to 2008.

When word of the coronavirus outbreak leaked out of China through social media on Dec. 30 last year, GPHIN’s intelligence gathering and surveillance capabilities had been significantly diminished. In his e-mail to GPHIN’s analysts, however, Mr. Burt expressed doubts that Canada’s response was slowed by the changes to the alert system.

However, that opinion puts Mr. Burt at odds with several of the scientists he oversees. One GPHIN employee said senior officials lacking a background in public health struggled to understand the purpose of the alert system.

Other internal department e-mails obtained by The Globe show Sally Thornton, vice-president of the Health Security Infrastructure Branch, and Jim Harris, director-general of the Centre for Emergency Preparedness and Response, oversaw the decision that curtailed alerts. An e-mail from late 2019 explaining the changes to staff summarizes the instructions given by “Jim and Sally.”

Rebuilding the pandemic warning and surveillance system will fall to a new set of managers.

Mr. Harris has since left the department, while the government said in a statement last month that Ms. Thornton retired. She departed about a week before the government announced the sudden resignation of Public Health president Tina Namiesniowski. The government has declined numerous requests by The Globe to speak to department officials.

Source: Ending Canada’s pandemic alert system was a mistake, internal government e-mails show

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Lapse in early pandemic warning system ‘a colossal failure,’ says former federal Liberal health minister Dosanjh

2020/09/29 3 Comments

Appears, if Minister’s spokesperson correct, decision was taken at the official not political level:

Following the abrupt resignation of the Public Health Agency of Canada’s (PHAC) president Tina Namiesniowski on Sept. 18, a former Liberal federal health minister says the lapse in the Global Public Health Intelligence Network (GPHIN)’s role under this government’s watch was “a colossal failure,” with the Bloc Québécois’ health critic saying the new president of PHAC will have to work hard to rebuild the agency “so that it can be more efficient in carrying out its duties [of] prevention, detection and management of public health crises.”

Former health minister Ujjal Dosanjh, who was in the role from 2004 to 2006 under then-prime minister Paul Martin, told The Hill Times that “the Public Health Agency isn’t an agency that’s supposed to sleep, ever. Its job is to continuously surveil, nationally, and internationally.”

“I think there is something the matter. If you are an activist minister, and you’re not just a politician who got elected, but you’re there to change the world even in the [most minute possible way], you would ask questions as to why GPHIN was folded. You would ask questions [about] when the information was coming from China,” Mr. Dosanjh said in a phone interview.

Canada was a leader in pandemic preparedness during his tenure, according to Mr. Dosanjh.

“I think it was a colossal failure on the part of government, and unfortunately no one is looking at these things because we are so wrapped up—and rightly so—dealing with the here and now, and we’re prepared to forgive the errors that have been made.”

“Whoever is responsible for it, it’s been a near fatal mistake in the pre-pandemic era which has come back to bite us in the pandemic era,” said Mr. Dosanjh, who also served as premier of British Columbia from 2000 to 2001.

“We would have been far better prepared, we would have had far more robust tools at our disposal, had we not put GPHIN to sleep,” said Mr. Dosanjh, who also noted that GPHIN was initially established following the SARS epidemic in the early 2000s.

“The infrastructure had been put in place before I got there, it was only completed when I got there, so I can’t take responsibly for it, but I’m somewhat saddened (which is not the best word), but knowing what I know, I’m angry,” said Mr. Dosanjh. “I’m actually sad at the kind of conflicting and unclear information that’s emanated from all of the responsible sources as COVID-19 started.”

Protecting the health and safety of Canadians ‘top priority’ 

According to Cole Davidson, spokesperson for Minister Hajdu, “protecting the health and safety of Canadians is our top priority.”

“Public health intelligence is vital to that goal,” said Mr. Davidson. “The minister was concerned to learn about the changes made to the Global Public Health Intelligence Network (GPHIN), and has ordered an independent review to look into these changes. The minister is expecting recommendations from this review in the next six months.”

“As the minister has said, these changes were made within the Public Health of Agency of Canada, not at the political level. These are serious and disturbing allegations—ones that we take seriously,” wrote Mr. Davidson. “When the minister became aware of these changes, she requested an independent review to investigate the questions that she had. GPHIN is an important tool for the government of Canada, and the analysts that serve this country must be empowered to do their work.”

PHAC’s president Tina Namiesniowski announced she was stepping down from the organization on Sept. 18, saying she was “now at a point where I need to take a break” and that she felt she “must step aside so someone else can step up” in a message to staff that day, according to multiple media reports.

Ms. Namiesniowski worked as a bureaucrat within the federal public service for decades, including stints as executive vice-president with the Canada Border Services Agency, as an assistant deputy minister at the Department of Agriculture, and as assistant secretary to cabinet, operations secretariat, with the Privy Council Office. She was appointed as president of the PHAC in May 2019.

‘There should be a strong public health capacity at different levels of government’

Dr. Paul Gully, a senior public health physician who was director of Health Canada’s population and public health branch and the department’s main spokesperson during the 2003 SARS outbreak, said he believes the Public Health Agency of Canada has responded well and continues to respond well to COVID-19.

“But I think lack of increased funding over the last few years, which probably goes back to the creation of the agency in 2014, is that it hasn’t been able to do a number of things,” said Dr. Gully. “One is to enhance its scientific capacity, while at the same time losing scientific capacity. It also hasn’t been able to deal with issues which have been well-known, such as the national emergency stockpile, for example.”

“There should be a strong public health capacity at different levels of government, that could then advise government and ensure that fiscal policies and all of the other policies are scientifically-based,” said Mr. Gully.

Government ‘asleep at the switch’ in ensuring strong PPE stockpile, says NDP’s Don Davies 

“I think the rapid removal of Ms. Namiesniowski and her rapid replacement is a clear acknowledgment that PHAC has been mismanaged for a long time now,” said NDP MP Don Davies (Vancouver Kingsway, B.C.), his party’s health critic. “The speed at which they replaced Ms. Namiesniowski, I think is also concerning.”

“Without casting any personal aspersions at the current appointment, the process makes me concerned,” said Mr. Davies.

“The Public Health Agency was slow to understand and acknowledge the risk level of COVID-19, they were slow to acknowledge community transmission, they were slow to acknowledge asymptomatic transmission,” said Mr. Davies. “They were also slow to acknowledge the efficacy of closing borders, and perhaps most egregious, they were completely asleep at the switch in making sure that we even had a good PPE stockpile.”

Bloc Québécois MP Luc Thériault (Montcalm, Que.), his party’s health critic, told The Hill Times that the “hasty and unexpected departure” of Ms. Namiesniowski will “definitely complicate the management of the current crisis.”

“But as the resignation of Mrs. Namiesniowski seems to be linked to personal burnout, it is difficult to blame her for this decision,” wrote Mr. Thériault in an emailed message to The Hill Times.“As for Mr. Iain Stewart, who has, it seems, a solid scientific profile, he will have to work hard to rebuild the Health Agency of Canada so that it can be more efficient in carrying out its duties [of] prevention, detection and management of public health crises. Especially since scientists warn us that such crises may be more common in the future because of increasing interference between human activities and nature, and accelerating climate change.”

Mr. Thériault also said that PHAC has shown “several shortcomings” in its handling of the COVID-19 crisis, and that the pandemic has shown that the agency isn’t adequately prepared to face such a crisis.

The government’s stock of masks and PPE was “clearly insufficient,” and PHAC erred by failing to heed warning from GPHIN about the pandemic, said Mr. Theriault.

“In addition, it was only two weeks after the onset of active community transmission and the rise in infections and deaths that the agency recommended social and economic restrictions, due to ineffective data collection,” he said.

“In short, PHAC must redefine its methods of preventing and preparing for future health crises, and it must make its responses to a public health crisis more rapid and effective. With the arrival of the new wave of COVID-19, it will have no room for error, as this wave had been expected for several months. We will be closely monitoring her actions in the face of this second wave.”

Mr. Thériault also said Quebec and the provinces were too much at the mercy of the ineffectiveness of PHAC.

“Indeed, they themselves suffer from systemic underfunding of their health system. That is why the Bloc Québécois, like Quebec and the provinces, is calling for an immediate [provision] of $28-billion in health transfers, an annual indexation of six per cent, and a federal contribution of 35 per cent,” said Mr. Thériault. “As health is a provincial responsibility, this will be the best way to prevent the different health systems from suffering once again from PHAC’s poor preparation for a future health crisis.”

Source: Lapse in early pandemic warning system ‘a colossal failure,’ says former federal Liberal health minister Dosanjh

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Public Health Agency head should have a science background, advisor says

2020/09/22 Leave a comment

Good summary of some of the issues regarding whether the head of PHAC should be a general administrator or one who also has a scientific or medical background (government announced the appointment of the president of the National Research Council, Iain Stewart, who also has extensive government experience):

With the government expected to name a new president of the Public Health Agency of Canada this week, a former top adviser says the COVID-19 pandemic has shown that the department needs a person with a science background at the helm, not an administrator.

After the sudden departure of president Tina Namiesniowski on Friday, the naming of a new leader is under heightened scrutiny. The resignation followed a string of problems associated with Canada’s pandemic preparedness and response over the past several months that were recently made public.

The government has signalled it will name a replacement as early as this week, but Michael Garner, a former senior science adviser and epidemiologist at the federal department, said the lessons of the pandemic are that a background in public health should be a primary requirement for the job.

“We can have all the expertise in the world working at PHAC, but if the leaders don’t understand public-health science, our pandemic response will continue to suffer,” Mr. Garner said. “It’s someone who can ask the right questions of the scientists. They have to be able to rapidly adjust as they get new information.”

Mr. Garner, who left Public Health last fall, is speaking out to The Globe and Mail on behalf of some of his former colleagues, including doctors and epidemiologists who still work at the department and are not authorized to speak publicly.

Several Public Health employees, who can’t be named owing to fears they could face reprisals, have told The Globe that they often struggled to communicate urgent and complex messages up the chain of command inside Public Health. Because senior officials within the department lacked an understanding of the science, key messages often had to be “dumbed down” one scientist told The Globe this summer.

Ms. Namiesniowski, who previously worked at the Border Services Agency, after roles with Agriculture and Public Safety, came to the agency with a political-science background. Vice-president Sally Thornton, who also left recently, had a background in law, and served in the Treasury Board and Privy Council before being appointed to a senior Public Health role.

Both oversaw critical aspects of the country’s pandemic preparedness and response systems. That included the handling of Canada’s early warning and surveillance unit, the Global Public Health Intelligence Network or GPHIN, which had its operations cut back last year, and the national emergency stockpile, which came up short in supplying personal protective equipment.

In an e-mail sent to staff, Ms. Namiesniowski said she needed a break, and was stepping aside to spend time with family. The e-mail indicated a new president for Public Health would be named early this week, suggesting the government already had a replacement for Ms. Namiesniowski in mind when her resignation was announced.

The selection of a new president has taken on increased importance with Canada seeing a spike in COVID-19 cases, and signs of a second wave of the outbreak emerging.

Canada’s pandemic response has been criticized for delaying critical decisions, and for underestimating the threat of the virus, particularly as the country curtailed much of its intelligence-gathering capacity by early 2019. That led to the government’s official risk assessments of the outbreak repeatedly labelling the virus a “low” risk to the country, even as it began to spread aggressively around the world in February and mid-March, and new evidence emerged about human-to-human transmission.

A Globe investigation in July detailed the problems inside Public Health, including the concerns from staff who said that science had been “devalued” within the department. Health Minister Patty Hajdu told The Globe those revelations were troubling.

“The pleas from the scientists and the researchers [inside Public Health] were particularly profound,” Ms. Hajdu said two weeks ago, as she ordered a federal review into the department’s handling of the pandemic early warning and surveillance unit, which was cut back against the protests of the scientists inside the department.

“The review, hopefully, will get at why are these processes in place, and are there better ways to manage?”

The Auditor-General has also launched an investigation of its own into the oversight of GPHIN and the decisions surrounding the intelligence-gathering unit.

Mr. Garner and several employees working inside Public Health say the department underwent a crucial shift in 2014, when the Conservative government revised the Public Health Act. That decision moved the leadership of PHAC from the Chief Public Health Officer, which is a public-health doctor, to the role of President, which became a government appointee.

While the Chief Public Health Officer is the face of the agency, and speaks directly to Canadians, the structural decisions for the department, which have the greatest influence over how the various programs operate, are made by the president.

Though the Liberals opposed the move when it was made, the structure remained in place when the government changed.

“This decision set PHAC on a course that has gravely influenced its ability to put into place the foundational elements required to proactively prepare for and effectively respond to the coronavirus pandemic,” Mr. Garner said.

Ms. Thornton has been replaced as vice-president by Brigitte Diogo, who recently worked in rail safety for the federal government. A spokesman for Public Health told The Globe that Ms. Diogo has experience in safety and security policy at Transport Canada and the Privy Council, and risk mitigation while at Immigration Canada.

Source: https://www.theglobeandmail.com/canada/article-public-health-agency-head-should-have-a-science-background-advisor/

 

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HHS Spokesperson Takes Leave of Absence After Disparaging Government Scientists

2020/09/18 Leave a comment

Posted given Canadian connection (Paul Alexander):

Michael Caputo, the top spokesperson for the Department of Health and Human Services and a longtime ally of President Trump’s, is taking a 60-day leave of absence after a social media tirade in which he falsely accused government scientists of engaging in “sedition.”

HHS announced the leave in a news release Wednesday, which said Caputo decided to take the two months off as the department’s assistant secretary for public affairs “to focus on his health and the well-being of his family.” In a statement, Caputo described the situation as a medical leave for “a lymphatic issue discovered last week.”

The leave of absence effectively removes Caputo from government operations through November’s election. The statement also announced that Paul Alexander, whom Caputo had brought in as a scientific adviser, would be leaving the department altogether.

Last week, Caputo came under fire after reports that he and Alexander sought to edit and delay public health reports from the Centers for Disease Control and Prevention. Emails from Alexander obtained by Politico complained to CDC Director Robert Redfield that the agency’s Morbidity and Mortality Weekly Report “hurt the President,” and described data-based publications on the risk of the coronavirus in children as “hit pieces on the administration” that undermined Trump’s school reopening plan. NPR has confirmed Politico’s reporting.

Regarding the reports of interference with the publication, “It’s very concerning, if people who are really motivated by politics and not by science and don’t have a scientific background are suddenly interfering,” said Erin Marcus, a physician at the University of Miami Health System and Public Voices fellow. “These actions have real effects on the health of our population and on our ability to function as physicians.”

In a Facebook Live video streamed on his personal page on Sunday, Caputo described a conspiracy in which policymakers, the media and “deep state” scientists are keeping Americans sick with COVID-19 to improve the Democrats’ chances of winning November’s presidential election. He accused “scientists who work for this government” of “sacrificing lives” for personal gain and of engaging in “sedition.”

His language echoed an Aug. 22 tweet from Trump accusing “the deep state, or whoever, over at the FDA” of deliberately delaying the recruitment of clinical trial participants for COVID-19 drugs and vaccines to hurt his chances of reelection. There is no credible evidence for these theories.

Caputo’s video, subsequently deleted, was first reported Monday by The New York Times. Clips from the video were later published by Yahoo News.

Caputo is a longtime Republican consultant who specializes in public relations. He joined HHS in mid-April at a time when the Trump administration was under heavy criticism over its handling of the pandemic. White House observersconsidered his appointment a move by the president to gain more control over the U.S. health department. In his five-month tenure as the top communications official, Caputo shaped messages from health agencies to align with the Trump administration’s political messaging in the heat of the COVID-19 pandemic.

Caputo is considered a Trump loyalist who was a communications director for Trump’s presidential campaign in 2016 — a role he resigned from after sending a public tweet celebrating Trump campaign manager Corey Lewandowski’s exit from the campaign.

While his social media tirade was highly unusual for a government spokesperson, Caputo promoted conspiracy theories about politics in Washington, D.C., before he joined the administration. In a March 13 episode of his former podcast Still Standing, first reported by Media Matters for America, he said Democrats wanted Americans to die from COVID-19 so they could unseat Trump in the next election. “How much does our economy have to die and how many Americans have to die for these Democrats to get what they want?” he asked rhetorically.

Caputo had previously been investigated over his ties to Russia, where he lived in the 1990s and was an adviser to the Russian government, during the Justice Department investigation into the 2016 presidential election campaign. In 2020, before joining the administration, Caputo released a book and a documentary called The Ukraine Hoax, pushing discredited claims that Ukraine’s government — and not Russia’s — had interfered with the 2016 U.S. presidential election.

Source: HHS Spokesperson Takes Leave of Absence After Disparaging Government Scientists

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