Government’s failure to keep stock of PPE reserves hurt us when we needed it most

Good commentary on the long history of government data management and use issues, brought to prominence during COVID-19, along with systemic accountability issues.

And yes, the default option for government data would be public (and to be fair, the open government initiative has resulted in more availability of data):

Seventeen years ago, there was a cabinet minister named Reg Alcock, the President of the Treasury Board, who invited people to his office for lectures about data.

The late Mr. Alcock was a hefty, 6-foot-8 mountain of a man with two main interests: Liberal Party organizing in Manitoba and dragging the government into the digital age. Part of the lecture he gave in 2004 was a question: Why is it that corporate executives have computers that can tell them, for example, how many trucks their company owns, but a prime minister would need a year to get the same answer from government?

On Wednesday, Auditor-General Karen Hogan issued a report on the government’s handling of stockpiles of PPE that let it be known that Mr. Alcock’s question is still hanging in the air, nearly two decades later.

Ms. Hogan’s team reported that the Public Health Agency of Canada (PHAC) had a stockpile of personal protective equipment and medical devices, but it didn’t have a policy about what should be in it, or what was in it, or whether the equipment had expired.

When the biggest public-health crisis of modern times hit and provinces needed N95 masks and ventilators from the National Emergency Strategic Stockpile, well, there wasn’t enough useful stuff there. The data were so unreliable the auditors couldn’t tell how badly it fell short.

The haphazard management of the stockpile wasn’t a new thing. Internal audits in 2010 and 2013 raised those issues.

Citizens might think a decade of disregarded warnings is a scandal that will shake the halls of power in Ottawa. But for a politician, it is cause for relief. The best kind of failure is one that was going on long before you took office. Prime Minister Justin Trudeau’s advisers will be happy enough that the Auditor-General credited the government for responding after the crisis hit.

But note that PHAC did draft a proposal to develop a better inventory management system in January, 2020 – just as COVID-19 was spreading – but agency officials told auditors “it was put on hold because of budget constraints.”

Mr. Alcock, back in the day, didn’t just want government to get computer systems – they have a lot – but to manage data, to make more information available and usable, so that government knows better what is happening within government.

But politicians in charge aren’t good at driving change in long-term, systemic issues that voters don’t even see. Mr. Alcock, for example, was preaching for IT in a Paul Martin government busy with Liberal scandals and non-confidence votes in Parliament.

Two PMs later, and governments still have a hard time seeing what government is doing. The National Emergency Strategic Stockpile wasn’t much use in a crisis because it didn’t do the kind of information management that that happens at a grocery store: figuring out what you will need, buying it, tracking what goes in and out and what is going bad.

By now we know that bad data management, not knowing what you don’t know, raises risk in a crisis. And there’s something else: Most of that data can and should be made public.

Why not let the public see the running tally of N95 masks in inventory, or ventilators on the web? Most people won’t look at it, but perhaps a few experts in universities and elsewhere will analyze the policies, crunch the data and, we can hope, point out when they’re messed up. Or just missing. That applies to other kinds of data, too.

In Britain, this week’s remarkable testimony of Dominic Cummings, a former aide to Prime Minister Boris Johnson, about the chaotic initial response to the pandemic made it pretty clear that it’s no longer necessary, or wise, to leave the data inside government.

Mr. Cummings testified to a parliamentary committee that false assumptions, bad analysis, and groupthink inside government led Mr. Johnson’s government to a disastrous notion that it should try to reach herd immunity rather than slowing the spread of COVID-19. Scientists outside government, notably a mathematician, helped convince him that was “catastrophically wrong,” he said. He and the government’s top science adviser later agreed data should have been released earlier, to get input.

That’s not the same thing as PHAC’s failure to keep track of a stockpile. But then, if we want to encourage the government to keep tabs on the data, one good way is to demand to see it.


GPHIN: Top scientists propose moving pandemic warning system outside government

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.”


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

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

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

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.


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



Ottawa appoints new management to ‘strengthen’ pandemic surveillance system

Needed given short-sightedness of PHAC-decisions regarding pandemic preparations:

The Public Health Agency of Canada has installed new management to oversee and “strengthen” the country’s pandemic surveillance system, a once-globally renowned unit whose capabilities were curtailed less than a year before the COVID-19 crisis hit.

In a statement provided to The Globe and Mail, the department said Brigitte Diogo, a senior official with 25 years of experience in government, has taken over as the vice-president of the Health Security Infrastructure Branch. The division oversees the government’s pandemic early warning and surveillance unit, known as the Global Public Health Intelligence Network, or GPHIN, among other operations, such as an emergency stockpile of medical supplies.

Sally Thornton, who previously served in that role, left the government last week, the department said. “After a long and distinguished career, Ms. Thornton is retiring from the federal public service,” Public Health spokeswoman Natalie Mohamed said in an e-mailed statement.

Ms. Thornton declined requests for an interview. Ms. Diogo was also not available for comment, the department said.

GPHIN has been at the centre of controversy since a Globe investigation in late July detailed how the intelligence-gathering capabilities of the government’s pandemic early warning system were reduced significantly in late 2018 and early 2019. That effectively shut down much of its surveillance work on international health threats less than eight months before the outbreak in China began to spread, and appears to have impacted Canada’s ability to gauge the risk of the virus.

Throughout January, February and much of March, the government judged the threat from the outbreak as “low” in its official risk assessments, even after the World Health Organization warned in late January that the risk to the world was high.

In her new role, Ms. Diogo’s mandate will include bolstering the surveillance system, although no specifics were provided.

“Ms. Diogo will lead efforts to maintain and strengthen Canada’s public health event-based surveillance system including the Global Public Health Intelligence Network,” department spokesman Eric Morrissette said in a statement.

In late 2018, believing that GPHIN was too internationally focused and could be put to better use on domestic projects, the department reassigned doctors and epidemiologists in the highly specialized unit to projects that didn’t involve pandemic preparedness. A once-prolific alert system operated by GPHIN, designed to track evolving health threats and inject urgency into government responses, was effectively shuttered when a new edict required that Ms. Thornton approve all such alerts.

With no approvals given, the alert system eventually went silent on May 24, 2019, according to 10 years’ worth of PHAC records obtained by The Globe. With it, much of the unit’s surveillance activities – designed to track early signals of an outbreak and inform government risk assessments – effectively shut down as well.

The alert system remained silent for 440 days, and was restarted only last month, less than two weeks after the Globe investigation. During the intervening months, employees inside Public Health say GPHIN’s intelligence-gathering abilities were a fraction of what they once were. Created in the 1990s, GPHIN had garnered international acclaim for its ability to detect and gather continuing intelligence on outbreaks of diseases such as H1N1, Ebola, Zika and others, helping the government formulate a response if needed.

In addition to GPHIN, Ms. Thornton also oversaw the national emergency stockpile of medical supplies, which came under heavy scrutiny this spring after it fell short of supplying the provinces and territories with badly needed personal protective equipment.

In April, Ms. Thornton testified before the House of Commons Health Committee that the stockpile held a “minimum level” of equipment, and wasn’t designed to handle the surge of a pandemic, raising questions about how it was being managed.

The Globe has made several requests since May to interview department officials connected to GPHIN, including Ms. Thornton. All of those requests were declined.

Last week, Health Minister Patty Hajdu ordered an independent federal review of the problems at GPHIN, saying she was troubled that scientists at Public Health told The Globe they were not being listened to within the department. The Auditor-General has also launched an investigation.

Scientists within Public Health told The Globe that over the past decade, the department has suffered from an influx of senior officials from other areas of the government, such as the Treasury Board, Border Services and others, who lacked sufficient grounding in Public Health. Epidemiologist Michael Garner, a former senior science adviser at the agency, said it became difficult for scientists to communicate urgent and complex messages up the chain of command, because those officials often didn’t comprehend the problems.

Ms. Diogo, who moves over from Transport Canada, has no science background, which may add to such concerns. However, Mr. Morrissette said she has extensive experience working on safety and security policy, and on program design and delivery.

“While a newcomer to the agency, Ms. Diogo understands the merit of a well-functioning, event-based surveillance system including the timely dissemination of information such as alerts, to inform decision-making in addressing public health threats,” Mr. Morrissette said.

According to information from the department, Ms. Diogo was director-general of rail safety at Transport Canada from 2015-20, and director of operations at the Security and Intelligence Secretariat in the Privy Council Office, where she oversaw matters related to national security from 2011-14. She also has a background in risk mitigation while at Immigration, Refugees and Citizenship Canada, the department said.

Source: Ottawa appoints new management to ‘strengthen’ pandemic surveillance system

Health Minister orders review of pandemic warning system, concerns raised by scientists

Really hope the review will be truly independent, review all appropriate documentation, analysis and memos and identify what level and persons were responsible for the decision (i.e., was the decision made at the bureaucratic or political level):

Canada’s Health Minister has ordered an independent review of the country’s pandemic early warning system, after The Globe and Mail reported that the respected surveillance and research unit was silenced last year, several months before the COVID-19 outbreak hit.

Health Minister Patty Hajdu said the federal review will probe the shutdown of the system, as well as allegations from scientists inside the Public Health Agency of Canada that their voices were marginalized within the department, preventing key messages from making it up the chain of command.

“My hope is that we can get the review off the ground as soon as possible,” Ms. Hajdu said in an interview. “The independence of this review is critically important.”

A Globe investigation in late July detailed how the unit, known as the Global Public Health Intelligence Network, or GPHIN, was effectively silenced in May, 2019. The team of analysts – including doctors and epidemiologists specially trained to scour the world for health threats – were reassigned to other tasks within the government amid shifting department priorities.

Though GPHIN had garnered a stellar reputation internationally, and was dubbed a “cornerstone” of global pandemic preparedness by the World Health Organization, officials within Public Health decided in late 2018 and early 2019 that the operation was too internationally focused and could be put to better use working on domestic projects. The new work did not involve pandemic preparedness.

Those changes led to the shutdown of a special surveillance and alert system that helped Canada and the WHO gather intelligence on potentially threatening outbreaks, particularly in situations where foreign governments were trying to hide or play down the event.

Current and former scientists and doctors at Public Health also said they began to fear that their messages were not being heard, or understood, by layers of department officials who lacked a sufficient background in science. That made it difficult to convey urgent and complex information up the chain of command.

Responding to those concerns, Ms. Hajdu said her office has spent the past month looking into the problems at the departmental level, which led her to order the review.

“I’m concerned when there is an accusation that scientists are not being fully empowered, or in some way feel their voices are being blunted or muted,” Ms. Hajdu said in an interview.

“I can listen to those kinds of worries and do the kinds of things that I’m prepared to do, which is to order a review of the program and to determine whether or not the changes are actually resulting in the kind of information that Canada needs.”

Ms. Hajdu said she has asked that the review be done expeditiously, so that fixes can be identified and the recommendations implemented as soon as possible. She said that could mean having the recommendations back in six months.

“We’re working on [appointing] some professionals that would have the experience and the expertise to be able to do this review thoroughly, but also expeditiously … I don’t want this to be a two-year review,” the Health Minister said. The people leading the review are expected to be named in the coming weeks and will be independent of Public Health Canada.

Created as an experiment in the 1990s, GPHIN became a key part of Canada’s pandemic preparedness capacity after the deadly 2003 SARS outbreak, and was seen as a way to collect intelligence on global outbreaks. The point was not merely to identify the threat early, but also to monitor crucial developments and clues about the spread, often before official announcements were made by foreign governments, to speed up government decision-making.

With a team of roughly a dozen highly specialized analysts working in multiple languages, GPHIN was globally renowned for its ability to collect and disseminate credible information. It scoured more than 7,000 data points a day, including medical data, news reports, scraps of information on social media, and details on internet blogs to gather intelligence on outbreaks.

GPHIN had been credited with detecting some of the most important signals from the 2009 H1N1 outbreak in Mexico, outbreaks of Zika in West Africa, and a potentially catastrophic 2005 bird flu outbreak that the Iranian government tried to hide. As recently as two years ago, the WHO credited the Canadian unit for supplying 20 per cent of its “epidemiological intelligence.”

However, department changes effectively shuttered the operation, and limited the power of scientists inside the agency. The Globe obtained 10 years of internal GPHIN records which showed the system, which had issued more than 1,500 intelligence alerts about potential health threats over that time, went silent on May 24 last year. That coincided with a department edict that all such alerts had to be approved by senior managers inside Public Health. GPHIN analysts were shifted to domestic projects, such as tracking the effects of vaping in Canada, which effectively curtailed Canada’s surveillance of international health threats.

Past and present employees told The Globe that the system was designed to provide information to speed up Canada’s response to a dangerous outbreak such as COVID-19, including measures such as shutting down the border, quarantining travellers, enforcing physical distancing, and locking down long-term care homes.

“A lot of the work that we’ve done [over the past month] is to try to dig a little bit deeper into how this is working and why were these changes made,” Ms. Hajdu said.

GPHIN “has the potential to be a very valuable asset for Canada. It can’t be wasted,” the Health Minister said.

“The intent when there is an emerging pathogen is to close it off, to try and contain it as best as possible – at its source. So that you don’t end up in a pandemic like this again.”

The independent review follows a pair of other developments in recent weeks. Last month, the Auditor-General of Canada launched an investigation into the shutdown of the pandemic surveillance unit. And Public Health officials have restarted the GPHIN alert system.

COVID-19 has been a reckoning for governments around the world, exposing weaknesses in pandemic readiness and responsiveness. Ms. Hajdu said countries must now take stock of what needs to be done to implement stronger measures, including early warning and surveillance capacity, that will remain effective and not be eroded over time, when the memories of the crisis fade.

The federal review will look at “governance and what works best” for GPHIN, Ms. Hajdu said, adding that the messages raised by scientists inside Public Health, who took risks by speaking out publicly, resonated with her.

“In [The Globe’s] reporting, the plea from the scientists and the researchers that work in that team were particularly profound,” Ms. Hajdu said.

“There is still enough there to save, and to boost, and I think this independent review is going to be very helpful,” she said. “Obviously there is a lot of work to do.”

Source: Health Minister orders review of pandemic warning system, concerns raised by scientists

Auditor-General to probe lapse in Canada’s pandemic warning system


Canada’s Auditor-General is planning to investigate what went wrong with the country’s once-vaunted early warning system for pandemics after the unit curtailed its surveillance work and ceased issuing alerts more than a year ago, raising questions about whether it failed when it was needed most.

Sources close to the matter said the Auditor-General is planning to probe the government’s handling of the Global Public Health Intelligence Network, or GPHIN, which was a central part of the country’s advance surveillance, early detection and risk-assessment capacity for outbreaks.

The Globe and Mail reported on Saturday that a key part of GPHIN’s function was effectively shut down last spring, amid changing government priorities that shifted analysts to other work. According to 10 years of documents obtained by The Globe, the system went silent on May 24 last year, after issuing more than 1,500 alerts over the past decade about potential outbreaks including MERS, H1N1, avian flu and Ebola.

GPHIN was part of Canada’s contribution to the World Health Organization. Those alerts often helped Canada, the WHO and other countries assess outbreaks at their earliest stages to determine the urgency of the situation. It was responsible for alerting the WHO to the first signs of several potentially catastrophic events, including a 2009 outbreak of H1N1 in Mexico, a 2005 flare-up of bird flu in Iran that the government there tried to hide, and the 1998 emergence of SARS in China.

According to federal documents, “approximately 20 per cent of the WHO’s epidemiological intelligence” came from GPHIN. But sources from inside the Public Health Agency of Canada (PHAC) said the analysts were stripped of their ability to independently issue alerts in late 2018. Those alerts, which had garnered GPHIN a global reputation as a leader in pandemic intelligence, had to be approved by senior management, a move that ultimately silenced the system.

Several past and present employees told The Globe that the government had grown wary of GPHIN’s mandate in recent years, believing it was too internationally focused, given that pandemic events were rare. Analysts were given domestic projects to focus on that didn’t involve global surveillance, and the operation’s early-warning capacity soon suffered. Over the past decade, doctors inside Public Health also began to fear their messages weren’t being heard, or understood, on important topics, the employees said, which affected Canada’s readiness for the COVID-19 pandemic.

The Auditor-General is also planning to look at Canada’s risk assessments during the pandemic, which may have affected the speed and urgency of mitigation measures, such as border closings, airport shutdowns and the use of protective masks. Throughout January, February and into March, the government maintained the risk the virus posed to Canada was “Low,” even as evidence of human-to-human spread became increasingly evident around the world. Canada didn’t elevate its risk rating to “High” until March 16, nearly seven weeks after the WHO declared the global risk was high and urged countries to start preparing.

The Office of the Auditor-General has previously signalled that it would be taking a critical look at the federal government’s response to COVID-19, but the probe of GPHIN is now among its top priorities, according to sources familiar with the matter. The sources were not authorized to speak publicly and the Auditor-General, as a matter of course, does not comment publicly on its investigations. The work is to be completed late this year or early next year.

“It’s still early in the process,” said Vincent Frigon, spokesman for the Office of the Auditor-General. “We don’t comment on ongoing audits, however when we do have a better idea of what’s the scope of the audit we should be able to release the information. … We should have a more specific timeline later this year.”

A PHAC spokesman said the agency would assist in the audit. “The Auditor-General plays an important role in Canada’s democracy as a key Officer of Parliament,” PHAC said in an e-mailed statement. “The Public Health Agency of Canada is fully prepared to assist the Office of the Auditor-General as they work on their audit of the Government’s pandemic preparedness and response.”

Few outside GPHIN knew the operation had curtailed its outbreak surveillance work to the extent it had. When a senior public health official addressed the WHO in November, the government described the system as still active. In a 2018 assessment of Canada’s pandemic preparedness capabilities, the WHO referred to GPHIN as the “cornerstone” of Canada’s pandemic response capability, and “the foundation” of global early warning, where signals are “rapidly acted upon” and “trigger a cascade of actions” by governments.

The unit, which involves roughly a dozen highly trained epidemiologists and doctors fluent in multiple languages, began as an experiment in the 1990s during the advent of the internet, but was elevated after the 2003 SARS crisis, when Canada realized it needed to be better prepared for serious outbreaks.

When fully operational, it was a combination of machine learning and human analysis, with GPHIN’s algorithms sifting through more than 7,000 data points from around the world each day, from local news reports and online discussions to arcane medical data, searching for unusual patterns. Those were then narrowed down for closer analysis by medical experts.