Canada has an access-to-information system in name only

Have encountered some of the same frustrations:

The Treasury Board is quietly conducting a long-promised review of the Access to Information Act, which governs how Canadians can obtain records held by the government. Unfortunately, these consultations appear to be more of a public relations exercise than a serious effort to improve Canadians’ right to access.

The original act dates to 1983 and has barely changed since then. It has not kept up with the advent of the internet, nor have fundamental weaknesses been fixed. Changes made by the Trudeau government in recent years have failed to fully open promised classes of records and have not advanced pro-active publication as far as needed.

Today, we have an access-to-information system in name only. A lack of firm timelines means requests regularly stretch on for months, if not years. Broad exemptions mean crucial information is withheld from the public. A culture of secrecy in many departments undermines the act almost entirely. The Office of the Information Commissioner is underresourced to handle the deluge of complaints.

The current review process is not going to fix all that. Unlike in past consultations, the Treasury Board is not releasing any kind of green paper or other consultative document to chart a course for the reforms, nor has the government sought independent expert advice.

A green paper is essential to capturing and conveying the essence of the innumerable public reports on problems with the system, which go back decades. Drawing on outside experts is equally important for any real reform agenda, especially one that might return the Canadian government to an equal footing with many allied jurisdictions. Canada was an early entrant into the arena of freedom of information; now we are a disappointing laggard.

Reform and revitalization of the Access to Information regime must include significant legislative changes, but must also consider the ecosystem in which it operates.

As it stands, the act allows for the government to exempt and withhold information “obtained in confidence,” information deemed “injurious to the conduct of international affairs,” virtually any information relating to defence and security, and nearly every record that could be described as providing “advice” to the government. These exemptions, as currently worded, simply reinforce practices of hoarding records and a culture of entrenched secrecy. We propose strict limitations on these exemptions, and a test that would require the government to prove the harm of releasing such information.

Some records are completely excluded at present, such as Cabinet confidences. These should be brought under the act, with appropriate restrictions so disputes over access to them can be adjudicated by the Information Commissioner. In addition, information practices are changing in government with ever greater reliance on text messaging, verbal briefings and other transitory material. The act should oblige all government agencies to properly document their decision-making processes and retain these records.

Equally important, a real public-interest override clause must be added, with an oversight role for the Information Commissioner.

There needs to be a declassification regime for all government records. Other governments declassify documents after 30 years or less: Canadians are lucky if these files are ever released. Library and Archives Canada, in particular, should play a role in receiving such records and educating Canadians on their importance.

Once processed and released to an individual requester, the information in question should be made publicly available on a consolidated and searchable government database, including both the metadata about the record and the record itself. We should do away with the wasteful cycle of returning records back into the hands of departmental gatekeepers after every request is fulfilled.

These measures need to be accompanied by a major change in culture within government, including a lowering of the walls of secrecy and an alignment between the Access to Information Act and the principles that underscored the National Security Transparency Commitment promised by the Liberal government in 2017.

A broken access system wastes government resources, does not serve Canadians and does not illuminate our governance history and practice. But it is not yet beyond salvation. The Treasury Board review needs to embrace a bold vision for the future and make a deep change to the legislation and administration of the act.

Dean Beeby is an Ottawa-based independent journalist, author and a specialist on freedom of information. Justin Ling is a freelance investigative journalist. James L. Turk is the director of the Centre for Free Expression at Ryerson University. Wesley Wark is a senior fellow at the Centre for International Governance Innovation.

Source: https://www.theglobeandmail.com/opinion/article-canada-has-an-access-to-information-system-in-name-only/

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

Case study of speaking truth to power:

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

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

Ontario is currently trending along the yellow line.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

That intense frustration was shared by many of his colleagues.

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

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

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

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

***

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

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

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

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

  • Reducing the list of essential workplaces allowed to remain open to be “as short as possible,” and ensuring that those workers wear masks on the job.
  • “Paying essential workers to stay home when they are sick.” And not, they note, the federal Employment Insurance benefit, which is “cumbersome” and inadequate.
  • Allocating as many vaccine doses as possible to hotspot communities and essential workers—and ensuring “on-the-ground community outreach” to connect doses to those workers.
  • Providing “public health guidance that works.” That means communicating a simple message: Indoor gatherings should be strictly forbidden, while underlining that “Ontarians can spend time with each other outdoors” while social distancing. That means allowing small gatherings of people from different households, while also encouraging masks and two metres distance.

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

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

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

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

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

One of the best overviews I have seen:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

And for good reason.

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

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

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

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

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

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

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

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

Source: How did it come to this?

@Justin_Ling: Canada’s public health data meltdown

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


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

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

Israel has the vaccines because it has the data.

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

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

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

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

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

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

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

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

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

***

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Provinces like Alberta bailed on Panorama in frustration.

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

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

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

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

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

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

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

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

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

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

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

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

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

“Inertia.”

***

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

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

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

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

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

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

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

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

The inefficiencies are glaring. But it gets worse.

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

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

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

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

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

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

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

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

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

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

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

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

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

”Including the current one.”

***

The barriers to improvement are lower than you might think.

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

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

But just adopting Panorama isn’t nearly enough.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source: Canada’s public health data meltdown