Cuts in Britain Could Cause a Covid Data Drought

2022/04/04 Leave a comment

Unfortunately, many governments are short sighted.

Canada did the same when it disbanded the Global Public Health Intelligence Network (GPHIN) the year before the pandemic, many provinces are no longer carrying out regular testing and reducing the frequency of reporting etc.

Interesting example of South Africa and how it is able to maintain monitoring at a reasonable cost:

The British government on Friday shut down or scaled back a number of its Covid surveillance programs, curtailing the collection of data that the United States and many other countries had come to rely on to understand the threat posed by emerging variants and the effectiveness of vaccines. Denmark, too, renowned for insights from its comprehensive tests, has drastically cut back on its virus tracking efforts in recent months.

As more countries loosen their policies toward living with Covid rather than snuffing it out, health experts worry that monitoring systems will become weaker, making it more difficult to predict new surges and to make sense of emerging variants.

“Things are going to get harder now,” Samuel Scarpino, a managing director at the Rockefeller Foundation’s Pandemic Prevention Institute, said. “And right as things get hard, we’re dialing back the data systems.”

Since the Alpha variant emerged in the fall of 2020, Britain has served as a bellwether, tracking that variant as well as Delta and Omicron before they arrived in the United States. After a slow start, American genomic surveillance efforts have steadily improved with a modest increase in funding.

“This might actually put the U.S. in more of a leadership position,” said Kristian Andersen, a virologist at Scripps Research Institute in La Jolla, Calif.

At the start of the pandemic, Britain was especially well prepared to set up a world-class virus tracking program. The country was already home to many experts on virus evolution, it had large labs ready to sequence viral genes, and it could link that sequencing to electronic records from its National Health Service.

In March 2020, British researchers created a consortium to sequence as many viral genomes as they could lay hands on. Some samples came from tests that people took when they felt ill, others came from hospitals, and still others came from national surveys.

That last category was especially important, experts said. By testing hundreds of thousands of people at random each month, the researchers could detect new variants and outbreaks among people who didn’t even know they were sick, rather than waiting for tests to come from clinics or hospitals.

“The community testing has been the most rapid indicator of changes to the epidemic, and it’s also been the most rapid indicator of the appearance of new variants,” said Christophe Fraser, an epidemiologist at the University of Oxford. “It’s really the key tool.”

By late 2020, Britain was performing genomic sequencing on thousands of virus samples a week from surveys and tests, supplying online databases with more than half of the world’s coronavirus genomes. That December, this data allowed researchers to identify Alpha, the first coronavirus variant, in an outbreak in southeastern England.

A few other countries stood out for their efforts to track the virus’s evolution. Denmark set up an ambitious system for sequencing most of its positive coronavirus tests. Israel combined viral tracking with aggressive vaccination, quickly producing evidence last summer that the vaccines were becoming less effective — data that other countries leaned on in their decision to approve boosters.

But Britain remained the exemplar in not only sequencing viral genomes, but combining that information with medical records and epidemiology to make sense of the variants.

“The U.K. really set itself up to give information to the whole world,” said Jeffrey Barrett, the former director of the Covid-19 Genomics Initiative at the Wellcome Sanger Institute in Britain.

Even in the past few weeks, Britain’s surveillance systems were giving the world crucial information about the BA.2 subvariant of Omicron. British researchers established that the variant does not pose a greater risk of hospitalization than other forms of Omicron but is more transmissible.

On Friday, two of the country’s routine virus surveys were shut down and a third was scaled back, baffling Dr. Fraser and many other researchers, particularly when those surveys now show that Britain’s Covid infection rates are estimated to have reached a record high: one in 13 people. The government also stopped paying for free tests, and either canceled or paused contact-tracing apps and sewage sampling programs.

“I don’t understand what the strategy is, to put together these very large instruments and then dismantle them,” Dr. Fraser said.

The cuts have come as Prime Minister Boris Johnson has called for Britain to “learn to live with this virus.” When the government released its plans in February, it pointed to the success of the country’s vaccination program and the high costs of various virus programs. Although it would be scaling back surveillance, it said, “the government will continue to monitor cases, in hospital settings in particular, including using genomic sequencing, which will allow some insights into the evolution of the virus.”

It’s true that life with Covid is different now than it was back in the spring of 2020. Vaccines drastically reduce the risk of hospitalization and death — at least in countries that have vaccinated enough people. Antiviral pills and other treatments can further blunt Covid’s devastation, although they’re still in short supply in much of the world.

Supplying free tests and running large-scale surveys is expensive, Dr. Barrett acknowledged, and after two years, it made sense that countries would look for ways to curb spending. “I do understand it’s a tricky position for governments,” he said.

But he expressed worry that cutting back too far on genomic surveillance would leave Britain unprepared for a new variant. “You don’t want to be blind on that,” he said

With a reduction in testing, Steven Paterson, a geneticist at the University of Liverpool, pointed out that Britain will have fewer viruses to sequence. He estimated the sequencing output could drop by 80 percent.

“Whichever way you look at it, it’s going to lead very much to a degradation of the insight that we can have, either into the numbers of infections, or our ability to spot new variants as they come through,” Dr. Paterson said.

Experts warned that it will be difficult to restart surveillance programs of the coronavirus, known formally as SARS-CoV-2, when a new variant emerges.

“If there’s one thing we know about SARS-CoV-2, it’s that it always surprises us,” said Paul Elliott, an epidemiologist at Imperial College London and a lead investigator on one of the community surveys being cut. “Things can change really, really quickly.”

Other countries are also applying a live-with-Covid philosophy to their surveillance. Denmark’s testing rate has dropped nearly 90 percent from its January peak. The Danish government announced on March 10 that tests would be required only for certain medical reasons, such as pregnancy.

Astrid Iversen, an Oxford virologist who has consulted for the Danish government, expressed worry that the country was trying to convince itself the pandemic was over. “The virus hasn’t gotten the email,” she said.

With the drop in testing, she said, the daily case count in Denmark doesn’t reflect the true state of the pandemic as well as before. But the country is ramping up widespread testing of wastewater, which might work well enough to monitor new variants. If the wastewater revealed an alarming spike, the country could start its testing again.

“I feel confident that Denmark will be able to scale up,” she said.

Israel has also seen a drastic drop in testing, but Ran Balicer, the director of the Clalit Research Institute, said the country’s health care systems will continue to track variants and monitor the effectiveness of vaccines. “For us, living with Covid does not mean ignoring Covid,” he said.

While Britain and Denmark have been cutting back on surveillance, one country offers a model of robust-yet-affordable virus monitoring: South Africa.

South Africa rose to prominence in November, when researchers there first discovered Omicron. The feat was all the more impressive given that the country sequences only a few hundred virus genomes a week.

Tulio de Oliveira, the director of South Africa’s Centre for Epidemic Response & Innovation, credited the design of the survey for its success. He and his colleagues randomly pick out test results from every province across the country to sequence. That method ensures that a bias in their survey doesn’t lead them to miss something important.

It also means that they run much leaner operations than those of richer countries. Since its start in early 2020, the survey has cost just $2.1 million. “It’s much more sustainable,” Dr. de Oliveira said.

In contrast, many countries in Africa and Asia have yet to start any substantial sequencing. “We are blind to many parts of the world,” said Elodie Ghedin, a viral genomics expert at the U.S. National Institute of Allergy and Infectious Diseases.

The United States has traveled a course of its own. In early 2021, when the Alpha variant swept across the country, American researchers were sequencing only a tiny fraction of positive Covid tests. “We were far behind Britain,” Dr. Ghedin said.

Since then, the Centers for Disease Control and Prevention has helped state and local public health departments start doing their own sequencing of virus genomes. While countries like Britain and Denmark pull back on surveillance, the United States is still ramping up its efforts. Last month, the C.D.C. announced a $185 million initiative to support sequencing centers at universities.

Still, budget fights in Washington are bringing uncertainty to the country’s long-term surveillance. And the United States faces obstacles that other wealthy countries don’t.

Without a national health care system, the country cannot link each virus sample with a person’s medical records. And the United States has not set up a regularly updated national survey of the sort that has served the United Kingdom and South Africa so well.

“All scientists would love it if we had something like that,” Dr. Ghedin said. “But we have to work with the confines of our system.”

Source: Cuts in Britain Could Cause a Covid Data Drought

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Globe editorial: Why did Ottawa kill GPHIN? Because politicians get no credit for averting a disaster that hasn’t happened yet

2021/07/14 Leave a comment

Of note, the overall challenge facing governments with respect to longer-term planning and preparation.

Silent on some of the internal decision-making processes that led to the weakening of GPHIN as it is still not clear whether the decision to shutter GPHIN was bureaucratically or politically-driven. Suspect the former given the small resources involved.

Somewhat normal to have tensions between scientific/medical experts and public service generalists but more serious in this case.

Notable recommendation that touches on this: 2.8 There should be sufficient public health expertise in GPHIN’s management to fully understand event-based surveillance.

A new independent review of the mismanagement of Canada’s pandemic early warning system, which was effectively shuttered by the Trudeau government in the months before COVID-19 made itself known in Wuhan, China, says all the right things.

Released Monday, the report urges Ottawa to better fund the Global Public Health Intelligence Network (GPHIN), and to make better use of the invaluable intelligence on disease outbreaks around the world that it gathers by scanning medical reports, media and other markers on a constant basis.

That, of course, is very good advice. It’s a given that, in the future, there will be more outbreaks in our connected world; it’s not a question of if, but when. Maintaining a well-funded early warning system, and creating a risk assessment group inside Canada’s Public Health Agency to analyze its finding and directly advise decision-makers, is a no-brainer.

But here’s the thing: Coming up with good advice on how to prepare for the next pandemic, and getting politicians to act on it, isn’t hard when a disease that has killed more than four million people worldwide, including more than 26,000 in Canada, is still spreading.

As the report itself says, “The best time to discuss pandemic preparedness is when it is most present in the minds of Canadians and of the governments who serve them.” 

Okay. But what happens in five or 10 years, if there’s been no outbreak in the interim, and those same governments start to lose interest in life-saving measures that don’t make headlines but which, if successful, prevent them?

The fate of GPHIN is just one of several glaring examples of what happens when Canadian governments decide that, since a disaster hasn’t happened recently, now must be a good time to cancel the insurance policy.

Created in the early 1990s, and eventually folded into the Public Health Agency of Canada, GPHIN was a world-leading scientific body that tracked outbreaks such as SARS, H1N1, MERS and Ebola, and shared its findings with the World Health Organization.

The Harper government indirectly weakened GPHIN in 2014, when it stripped PHAC of some of its independence. But the Trudeau government delivered the coup de grace in May of 2019, when it told GPHIN to stop its international monitoring and focus on domestic outbreaks.

It’s impossible to say for sure that turning off Canada’s early warning system contributed to Ottawa’s sluggish and confused response to the COVID-19 outbreak in early 2020. It certainly didn’t help.

What may be more important, though, is how the evisceration of GPHIN fits a pattern in Canadian politics.

For instance, after the scare of the SARS epidemic in Toronto in 2003, Ontario’s Ministry of Health and Long-Term Care prepared for a future outbreak by spending $45-million on 26,000 pallets of masks, face shields, needles, disinfectant wipes, disposable thermometers and other vital medical equipment.

But in 2017, the province’s Auditor-General found that more than 80 per cent of the supplies were no longer usable. The stuff had been left to rot, because the government never allocated money to manage and replenish the stocks.

In another example, this one from before the SARS crisis, the Ontario government in 2001 laid off a group of PhD-level scientists hired to watch for emerging diseases. “Do we want five people sitting around waiting for work to arrive?” a Health department spokesman asked at the time.

Yes. Yes we do.

This is going to be the real test of Canada’s postpandemic response: Can measures urgently agreed to while COVID-19 is still an omnipresent threat survive subsequent governments that start to chafe at the independence that GPHIN and PHAC need in order to do their jobs, or become annoyed at money being spent on what may at times look like just a bunch of scientists sitting around waiting for a crisis to arrive?

The GPHIN report is wrong: The best time to discuss pandemic preparedness is not when it is top of mind, but when it has receded to the background and there is no political gain to be had by talking about it.

That’s the critical moment. Canadians won’t automatically be at risk the next time a virus threatens to become a pandemic somewhere on the planet. The danger will come before that, when governments decide to cut back on the vital but unheralded work that could have kept them safe.

Source: https://www.theglobeandmail.com/opinion/editorials/article-why-did-ottawa-kill-gphin-because-politicians-get-no-credit-for/

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GPHIN: Top scientists propose moving pandemic warning system outside government

2021/04/07 Leave a comment

Understand and share the concerns, but I would prefer to address these and related problems at PHAC identified by media coverage and the recent OAG report.

The WHO also had its issues, relying too much on Chinese government information (or lack thereof).

But hopefully this initiative will increase government focus and attention that COVID has brought to current weaknesses:

A group of top scientists concerned about the decline of the federal pandemic early warning system in the years before COVID-19 emerged have proposed relocating the operation to a university where it can work independently of government.

The proposal is aimed at restoring the Global Public Health Intelligence Network to its former status as an internationally respected pandemic surveillance system. Documents outlining the plan were submitted to an independent panel in Ottawa that is reviewing the system’s future.

According to the documents, GPHIN would work with the World Health Organization and be based at the University of Ottawa’s Bruyère Research Institute. The university and the WHO back the idea, says the proposal, which was reviewed by The Globe and Mail.

“We propose the creation of a Canadian-based WHO collaborating centre for global health intelligence,” the proposal states. Such a move “would provide a new, stable and cost-effective environment for the future management of GPHIN.

“GPHIN must be guaranteed freedom from government influence or interference. To achieve independence of any future government influence, bias or interference, GPHIN must be situated outside of government.”

A Globe and Mail investigation last year found that GPHIN’s capabilities had been allowed to erode over the past decade as priorities within the government changed, and senior officials in the Public Health Agency of Canada (PHAC) sought to deploy its resources elsewhere.

Some of the core functions of the system, which provided crucial intelligence before and during the 2003 SARS crisis and 2009 H1N1 outbreak, were silenced in 2018 and 2019. With no pandemic threats apparent, management in the department sought to shift resources to areas that didn’t involve outbreak surveillance.

The proposal to partner with the WHO is being led by Ron St. John, a former top federal epidemiologist who helped create GPHIN in the 1990s, and other current and former top federal scientists. If it succeeds, the operation would run as a non-profit, funded in part by the federal government, and also able to seek science and technology grants from other sources, which it currently cannot do.

That new funding would be used to rebuild GPHIN’s operations and expand the system’s technical capabilities, taking some of the financial burden off the government, the documents say. GPHIN’s annual budget is around $3-million, and federal documents show it lacked the resources needed to update or grow its surveillance capacity, particularly as the system was allowed to erode.

The proposal argues that the environment needed to properly run the pandemic early warning system no longer exists inside Public Health, due to a drain of scientific and medical expertise over the past decade.

“Meeting these principles and operational conditions is not possible within the current managerial environment that exists in PHAC,” the document states. “We cannot wait for these changes to happen, as waiting will result in irreversible degradation of GPHIN and further depriving users within the global public health surveillance community of an essential tool to detect and monitor public health threats.”

WHO collaborating centres around the world are a way for member countries to contribute resources to the WHO by offering skills or technology they have. The Bruyère Research Institute is already home to one such collaborating centre, which focuses on technology used to track global health equity.

At one time, GPHIN provided the WHO with as much as 20 per cent of its epidemiological intelligence, according to Ottawa’s records. The proposal documents say GPHIN would remain one of Canada’s key contributions to the WHO, with the government providing funding for the system’s analysts to work.

Health Minister Patty Hajdu ordered an independent review in September of how PHAC handled the system after a Globe investigation last summer detailed many of the problems.

A report by the Auditor-General of Canada issued two weeks ago also found that the federal government did not use the pandemic early warning system appropriately in the early days of the COVID-19 outbreak, and that GPHIN failed to issue alerts. This contributed a series of faulty risk assessments as the virus began to spread around the world.

The independent review is expected to issue its final report in May, and the government won’t comment on its progress.

This is not the first time the idea of a WHO collaborating centre has been proposed for GPHIN. The proposal documents say the WHO has supported the idea since the SARS crisis, and has held talks on the subject six times, but those negotiations never came to fruition.

In 2005, talks were put on hold amid management changes inside Public Health. In 2009, similar discussions were halted due to the H1N1 outbreak. In 2012, another proposal was frozen during the Harper government’s deficit reduction plan. Similarly, talks in 2013, 2017, and 2018 never progressed due to internal restructuring in the Public Health Agency that resulted in management changes, and no further steps were taken.

The push to rebuild GPHIN comes at a time when other countries have identified the need to build their own early warning systems to help the international community detect major threats early and better contain outbreaks. The U.K. government and the Biden administration in the United States have signalled plans to bolster such capacities in recent months. An independent review examining the WHO’s pandemic preparedness is also expected to highlight the importance of such systems in its final report, expected this spring.

The epidemiologists behind the proposal say they want to restore Canada’s leadership in pandemic early warning and detection.

“GPHIN has achieved world-wide recognition as a rapid provider of accurate information regarding a variety of global events of public health importance,” the proposal says. “Future versions of GPHIN must build on and maintain this pre-eminent position. It’s Canadian origin and Canadian support during its lifetime is recognized and should be retained.”

Source: https://www.theglobeandmail.com/canada/article-top-scientists-propose-moving-pandemic-warning-system-outside/?utm_medium=email&utm_source=Morning%20Update&utm_content=2021-4-6_7&utm_term=Morning%20Update:%20Top%20scientists%20propose%20moving%20pandemic%20warning%20system%20outside%20government&utm_campaign=newsletter&cu_id=%2BTx9qGuxCF9REU6kNldjGJtpVUGIVB3Y

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PMO scrambled to contain controversy over pandemic early-warning system, internal e-mails show

2021/03/06 4 Comments

Makes pretty clear that failure was at the senior bureaucratic level:

Internal e-mails show the Prime Minister’s Office was scrambling last summer to contain the fallout over the silencing of Canada’s pandemic early-warning system after learning it was curtailed less than a year before COVID-19 struck.

The e-mails, which provide a rare look at exchanges between the Prime Minister’s top political aides, show the upper levels of government were caught off guard when details about the silencing of the Global Public Health Intelligence Network (GPHIN) were made public by a Globe and Mail investigation.

The internationally respected system was created to detect and monitor international health threats to help Canada and other countries respond faster and more effectively to a deadly outbreak. However, The Globe found that the operation’s alert system was silenced in early 2019 amid shifting government priorities.

During an exchange of early-morning e-mails on Aug. 13, advisers to the Prime Minister can be seen trying to figure out what went wrong with GPHIN, and whether the blame for its mishandling could be contained to the Public Health Agency of Canada (PHAC), and decision makers within that department, without political ramifications for the government.

“Can you confirm all the decision are internal to PHAC?” Samantha Khalil, the PMO’s deputy director of issues management, said to a colleague in an e-mail at 8:33 a.m. “I’ve got a hard deadline of 8:45 now to update my senior team.”

That morning, The Globe reported the pandemic alert system was suddenly restarted about two weeks after it published its investigation that showed GPHIN had gone silent in 2019. The shutdown of the alert system, and its reinstatement, appear to have blindsided the government.

At 7:15 a.m., the Prime Minister’s chief of staff, Katie Telford, sent an e-mail to PMO staff with the article attached, saying, “Front page of globe. How will we respond to this?” The replies to that e-mail paint a picture of the Prime Minister’s Office trying to find answers, and concerned with whether the blame will spread beyond the Public Health Agency.

Responding to Ms. Telford’s e-mail at 8:03 a.m., PMO senior adviser Ben Chin told colleagues: “The thing I’d like to understand better is whether all decisions on this are internal to PHAC. I understand there was no funding reduction.”

In another e-mail, Ms. Khalil asks a colleague: “Can you send me any background there is on why this was stopped and restarted? As well as your messaging on it.”

At 8:53 that morning, Cole Davidson, press secretary to the Minister of Health, responds to Ms. Khalil, “We’re working on getting specifics and answers to some questions. … When did this change happen? Why did this change happen? Who made the decision?”

The e-mails are among thousands of federal documents being disclosed in response to a production order for COVID-19 records that the House of Commons approved in October despite objections from the Liberal government.

Before it was curtailed, GPHIN was internationally renowned for tracking deadly outbreaks, and provided the World Health Organization with 20 per cent of its epidemiological intelligence that fed global advance warnings. The system was used effectively during H1N1 and Ebola, helping governments respond swiftly to contain those deadly outbreaks. However, in 2018, with no pandemic threats on the horizon, senior management reallocated some of GPHIN’s resources to domestic projects.

As PMO officials arranged a 10 a.m. briefing from Public Health Agency officials that morning, they also worked on the messages that would be delivered to Canadians on the matter.

At 11:16 a.m., after the briefing, Mr. Davidson e-mailed Ms. Khalil with an update. That e-mail confirmed several key details of The Globe’s investigation, which reported that, in late 2018, managers at Public Health began requiring GPHIN analysts to obtain senior-managers’ approval before issuing alerts. This effectively suffocated the early warning system. When approvals never came, the international alerts stopped. Meanwhile, GPHIN analysts were reassigned to tasks that did not involve international outbreak surveillance.

“A new process was put in place requiring approval of all alerts by a VP at PHAC in fall of 2018,” Mr. Davidson reported to the PMO. “This change was not supported by the GPHIN analysts.”

He also confirmed the silencing of the alert system, which Public Health had initially told The Globe last summer did not occur. “From May, 2019, until last week, no alerts were issued,” Mr. Davidson told the PMO.

“PHAC is getting us answers on these questions: Who made the decision to change the approvals? Why was this change necessary? Was MinO briefed on this change? (we don’t believe so),” Mr. Davidson wrote, referring to the Health Minister’s Office as MinO. “Why did the alerts nearly stop after the change?”

Three weeks later, Health Minister Patty Hajdu ordered an independent federal review of the way GPHIN was handled. The Auditor-General has also launched an investigation.

Department management has also been shuffled amid the GPHIN controversy. The president of the Public Health Agency stepped down in September, and was replaced by the head of the National Research Council, while the government appointed a new vice-president to oversee GPHIN.

Source: PMO scrambled to contain controversy over pandemic early-warning system, internal e-mails show

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Federal documents show sharp decline of Canada’s pandemic warning system, and debate over who was to blame

2021/02/26 2 Comments

Looks like decision was mainly at the bureaucratic, not political level:

Newly released government documents paint a stark picture of how quickly Canada’s pandemic early warning system fell into decline before COVID-19 hit.

E-mails between staff at the Prime Minister’s Office show how alerts issued by the Global Public Health Intelligence Network, or GPHIN, dropped precipitously from 2009 to 2019, when key parts of the operation were curtailed.

The numbers confirm internal Public Health Agency data obtained by The Globe and Mail last summer, which showed how Canada’s internationally renowned pandemic early warning system was effectively shuttered less than a year before COVID-19 began spreading.

GPHIN was created in the 1990s to provide Canada and its allies with the earliest possible warnings of outbreak threats, so that governments could move quickly and decisively. A Globe investigation last year detailed how GPHIN played an integral role in detecting and helping the international community respond to past outbreaks such as SARS, H1N1 and MERS.

The e-mails between PMO staff are part of a release of thousands of federal documents that are being disclosed in response to a production order for COVID-19 records that was approved by the House of Commons in October over objections from the Liberal government.

In those e-mails, PMO advisers are responding to The Globe’s GPHIN investigation, which reported that the pandemic early warning system had issued more than 1,500 alerts on potential outbreak threats between 2009 and 2019. The probe found that GPHIN suddenly fell silent on May 24, 2019, less than eight months before COVID-19 started to become a world crisis.

The investigation detailed how shifting priorities within Public Health led to GPHIN’s resources being moved to other areas. With no apparent pandemic threats on the horizon, analysts were reassigned to study domestic issues, such as the effect of vaping and the spread of syphilis in Canada. When GPHIN’s alert system went silent last year, its surveillance of international outbreaks was also significantly curtailed.

According to an e-mail between PMO staff on Oct. 8, GPHIN issued 1,598 alerts between 2009 and 2019, including 877 in 2009, the year of the H1N1 outbreak. These alerts spanned a wide range of threats – from Zika to Ebola, yellow fever and Crimean-Congo hemorrhagic fever – and most never evolved into a crisis, though GPHIN would have kept close tabs on each situation as needed.

But the numbers began to decline sharply. After issuing 198 alerts in 2013, when an outbreak of H7N9 bird flu emerged, GPHIN’s alerts dropped in half the following year and soon declined further. By 2018, GPHIN issued just 21 alerts, a drop of 97 per cent from 2009 levels.

The e-mails suggest that as staff inside the PMO deliberated on how to respond to The Globe’s investigation, they appeared concerned about whether the Liberal government could be blamed for financial cuts to the operation, or whether the decisions that shifted GPHIN’s focus and resources inside the department rested solely with the Public Health Agency of Canada (PHAC).

“PHAC may have reprioritized its efforts, but it is an Agency that gets to decide, to an extent, their own priorities – those would be internal, bureaucratic decisions, not political ones,” Elise Wagner, a senior special assistant in the PMO wrote to a colleague. “Our government did not cut funding for the global early warning system.”

The shuffling of resources within the department had a significant effect, though. GPHIN’s role was not only to detect the first signs of an outbreak, but to provide continuing, rapid intelligence of an evolving situation, so that Ottawa could quickly bolster stockpiles of personal protective equipment and ensure hospitals and long-term care homes were ready if needed.

The goal was to inject urgency into government decisions, including when to implement physical distancing, mask wearing and stricter border measures. However, scientists inside PHAC told The Globe that they struggled to get important messages up the chain of command.

Members of the Canadian intelligence community have since raised concerns about the curtailing of GPHIN, given its role in informing the government’s risk assessments on COVID-19. Through January, February and into March of 2020, Ottawa rated the outbreak a low threat to the Canadian public, even as evidence emerged about how deadly the virus was and how easily it was spreading, and despite other countries implementing unprecedented measures.

Faced with criticism over the government’s early response, Prime Minister Justin Trudeau said he wasn’t sure what role added intelligence could have played in Ottawa’s decisions, but said he regrets not acting sooner to bolster stockpiles of personal protective equipment. However, informing such decisions is exactly what GPHIN was created to do.

The federal documents show GPHIN first picked up on the outbreak on Dec. 31, 2019, after news of a strange pneumonia in China made international headlines and a New York based disease-tracker called ProMed issued an alert to doctors and hospitals around the world. Scientists now believe COVID-19 had likely been spreading several weeks by that point, and that China did not fully disclose the problem.

Epidemiologists say the speed at which governments can implement containment measures has a major effect on the spread of a virus and its death toll, even if only by a few days or a week.

The problems surrounding GPHIN are now the subject of two federal probes; the Auditor-General of Canada has launched an investigation while the Minister of Health has ordered an independent federal review. The results of both are expected sometime this spring.

Source: Federal documents show sharp decline of Canada’s pandemic warning system, and debate over who was to blame

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Military medical intelligence warnings gathered dust as public health struggled to define COVID-19

2021/01/12 Leave a comment

Sigh… Yet another oversight. So PHAC relied exclusively on the WHO which appears to have relied exclusively on the Chinese government, and did not explore other data sources:

Public health officials failed to cite early warnings about the threat of COVID-19 gathered through classified military intelligence as the pandemic crisis emerged a year ago, CBC News has learned — an oversight described as a strategic failure by intelligence and public health experts.

For over seven decades, Canada and some of its closest allies have operated a largely secret formal exchange of military medical intelligence. That relationship regularly produces troves of highly detailed data on emerging health threats.

The small, specialized unit within the Canadian military’s intelligence branch began producing warnings about COVID-19 in early January of last year — assessments based largely on classified allied intelligence. Those warnings generally were three weeks ahead of other open sources, say defence insiders.

But documents show the Public Health Agency of Canada’s (PHAC) COVID-19 rapid risk assessments — which politicians and public servants used to guide their choices in early days of the pandemic — contained no input from the military’s warnings, which remain classified.

Three of the five PHAC risk assessments — obtained under access to information law by one of the country’s leading intelligence experts and CBC News — show federal health officials relying almost exclusively on assessments from the World Health Organization.

Even those writing the risk assessment reports acknowledged the dearth of intelligence.

Confidence level ‘low’

“Due to the limited epidemiologic data from China, and limited virologic information available for the etiologic agent, the confidence level for this assessment is considered as ‘low’ and the algorithm outputs remain uncertain at this time,” said the Feb. 2, 2020 PHAC risk assessment report.

The analysts at PHAC were uncertain because — as the world learned later — China was stonewalling the WHO about the extent of the Wuhan outbreak and assuring international health experts that everything was under control.

Meanwhile, in the military medical community, alarm bells were ringing. In the U.S., the National Center for Medical Intelligence (NCMI), located in Fort Detrick, Maryland, was not only gathering raw intelligence through various classified means — it was producing comprehensive assessments of the trajectory of the virus as of last February.

“This coronavirus pandemic is right in their wheelhouse, which is part of their core mission — to be on the lookout for any early indications of infectious disease,” said Dr. Jonathan Clemente, a physician practicing in Charlotte, North Carolina who has researched and written extensively about the history of medical intelligence.

‘Strategic surprise’

The original purpose of military medical intelligence among the allies was to assess sanitary and health conditions in the places around the globe where their troops were deployed.

But over the years, Clemente said, the mandate evolved to include “preventing strategic surprise” — such as pandemics and deliberate biological attacks.

“So there’s a wide range of reports, from your short-form daily bulletins to long-form assessments,” he said.

“It’s important to know that this is different from, say, the World Health Organization because the NCMI has access to all-source intelligence, meaning they have access to the most secret levels of intelligence, including clandestine human reporting, satellites, signals intelligence and … open  reporting.”

The information gathered through such intelligence channels would be knowledge “that other traditional health care and public health agencies” don’t have, he added. It’s also the kind of knowledge that would have informed the Canadian military’s medical intelligence branch as the pandemic was gathering momentum.

‘A terrible failure’

The fact that PHAC didn’t track what the military medical intelligence branch was seeing, coupled with changes to the federal government’s own Global Pandemic Health Information Network (GPHIN), represent “a terrible failure,” said Wesley Wark, a University of Ottawa professor who studies intelligence services and national security. He requested the documents through the access to information law.

The auditor general is reviewing what went wrong with the country’s early warning system, including the risk assessments. Flaws in those assessments may have affected the introduction of anti-pandemic measures such as border closures and mask mandates.

A second, separate independent review of Canada’s early pandemic response has been ordered by Health Minister Patty Hajdu.

CBC News first reported last spring that the military medical intelligence branch (MEDINT) began writing reports and issuing warnings about COVID-19 in January 2020. At the time, a spokesperson for MEDINT would not comment “on the content of intelligence reports that we receive or share.”

A follow-up investigation by CBC News has shed more light on the long-established secret network the allies use to warn each of health threats.

It’s governed by an obscure forum going by a rather clunky name: the Quadripartite Medical Intelligence Committee (QMIC).

A ‘Five Eyes’ network for pandemics

Originating in the Second World War, the forum allows the American, Canadian, British and Australian militaries to exchange classified global health data and assessments about emerging health threats.

Clemente describes it as the medical equivalent of the better-known Five Eyes intelligence-sharing alliance between Canada, the United States, Great Britain, Australia and New Zealand.

Clemente said that, through U.S. freedom of information law, he has compiled a comprehensive, declassified portrait of the deep health intelligence ties between allies — especially between Canada and the U.S.

He said he also has collected reports and analyses on how NCMI tracked and assessed previous pandemics and disease outbreaks, including SARS, H1N1 and Ebola.

Those assessments — copies of which were obtained by CBC News — are very precise and complete. The U.S. military’s assessments of the novel coronavirus and the disease it causes remain classified, but Clemente said it’s certain that NCMI was doing similar surveillance on COVID-19 which would have been shared with allies.

Wark said Canada’s public health system was redesigned almost two decades ago with the aim of preventing “strategic surprise,” but many of initiatives planned or implemented following the SARS outbreak were allowed to wither away and die.

One 2004 proposal which fell by the wayside was to find a mechanism that would allow PHAC to seamlessly incorporate classified intelligence into its system of reporting.

Greg Fyffe, the former executive director of the Intelligence Assessment Secretariat in the Privy Council Office (which supports the prime minister’s office), said military medical intelligence assessments rarely came across his desk during his tenure a decade ago.

He said that when intelligence reports reach the highest levels of government, they often arrive in summary form and analysts occasionally have to seek out more details.

“There’s so much intelligence information out there that it’s not a matter of saying … ‘I have a little bit of something that you’d like to see,'” said Fyffe. “We’re talking about huge volumes of material which can’t all be shared.”

In a year-end interview with the CBC’s Rosemary Barton, Prime Minister Justin Trudeau dismissed the suggestion that better early warnings could have stopped COVID-19 from spreading to Canada.

“I think we used all the resources that we always have to follow and monitor,” he said. “I don’t know that it would have made a huge difference for us to have extra reporting on top of what we were getting.”

The prime minister said that, in hindsight, there were things “we probably would have wanted to have done sooner in terms of preparing,” such as bolstering stocks of personal protective equipment (PPE) and other medical supplies.

‘We could have been much better prepared’

Defence Minister Harjit Sajjan indicated in a year-end interview that he shared the information he had and there were “many conversations” within the government.

While he cautioned that military intelligence alone can’t cover global disease surveillance, he did acknowledge that Canada’s early warning mechanisms need a serious review “from a whole-of-government perspective … making sure we have the right sensors out.”

Preparation is the whole point of early warning, said Wark, who agreed with Trudeau’s assessment of the volatility of the novel coronavirus’s transmission.

“We wouldn’t have stopped it from coming to Canada,” said Wark. “That would have been impossible. But we could have been much better prepared to meet its onslaught, and we were not. We suffered a terrible failure of early warning, of intelligence, of risk assessment.

“And the main lesson that has to be drawn … from the experience of COVID-19 is that we have to fix all of those things. We have to have a better early warning system.”

Source: Military medical intelligence warnings gathered dust as public health struggled to define COVID-19

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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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