Dr. John Hollins, past chair, Canadian Club of Rome, states:
SUMMARY and OPINION by John Hollins
2020 June 28
This text is based primarily on an extensive report in the Globe and Mail: Lost months. During two months, three reporters interviewed more than 50 individuals involved in Canada’s pandemic response in order to understand how the outbreak unfolded.
Risk low … really?
The risk of an outbreak in Canada remains low tweeted Theresa Tam, Canada’s Chief Public Health Officer on January 25.
Between January 26 and 30, however, Dr. Monir Taha, an associate medical officer of health with Ottawa Public Health, wrote a series of e-mails to high-ranking Ontario health officials.
Dr. Taha and other health experts across the country were deeply concerned that Dr. Tam was wrong. On January 28, he wrote: Canada’s goal of containment has a considerable probability of failure given the current strategy. Hindsight has established that the foresight of Dr. Taha and others was correct.
Flights from China
Dr. Taha continued: Flights from China should be prohibited now (January 28) until the epidemic is under control. He anticipated correctly that this would not happen.
At its corporate initiative, however, Air Canada halted flights to China on January 29. The Government of Canada did not require it to do so. And three Chinese airlines continued to fly.
At the time, a federal travel advisory simply offered routine advice, asking Canadians to avoid all non-essential travel to mainland China. It read: The decision to travel is your choice, and you are responsible for your personal safety abroad.
The advisory was not a ban. This advice completely missed the point, which was not the well-being of travellers, but their potential to bring the virus to Canada.
Starting in late December, dozens of other nations implemented travel-related measures, including outright bans. It took until March 16 for the Government of Canada to ban the entry of all non-Canadian or non-permanent residents into Canada.
The common thread among the stories gathered by the Globe and Mail is that Canada’s response was mounted not as one country, but in silos. The shortcomings were the same as those that hampered Canada’s response to the Severe Acute Respiratory Syndrome (SARS) outbreak 17 years ago.
Reviews following SARS found that public health bodies should follow the precautionary principle. When faced with a little-known pathogen, it is better to err on the side of caution. Hesitation can cost lives. Overreacting is better than the alternative.
During the first pivotal months of the outbreak of COVID-19, the opposite generally occurred in Canada. A notable exception was British Columbia, whose approach was to err on the side of caution.
Canada’s first case was confirmed on January 24. Public health officials held news conferences to reassure the public. Prime Minister Justin Trudeau echoed this message on January 29.
The Prime Minister’s Chief Science Advisor, Dr. Nemer, saw it differently. She saw the developments in China as clear signals that the situation was gravely serious. This is a viral infection that can travel the world and there was no reason to believe that anybody would be spared or that the impact of the infection would be easier in different countries than in China.
There are economic and political reasons not to close borders observed Srinivas Murthy, an infectious disease specialist with the University of British Columbia. He said that a mandatory 14-day quarantine would be more effective.
Quarantine or questions?
But quarantines weren’t enacted in a timely manner. Instead, air travellers from China arriving in Toronto, Montreal and Vancouver were simply asked to self-identify if they had any flu-like symptoms. This was less effective than temperature screening, which had been implemented in a number of countries. Human nature, being what it is, suggests that some travellers will not respond fully to such simple screening questions in the absence of any other measures.
Dr. Michael Gardam, a former Medical Director of Infection Prevention and Control at the University Health Network, said that it’s not surprising that epidemiologists who are not hampered by politics would be way out ahead of [officialdom]. The frustrating part was they didn’t feel they were listened to. And to this day, people are still about wondering who is giving the government advice.
Dr. Gary Kobinger, the director of the Research Centre on Infectious Diseases at Laval University and a former chief of special pathogens at the National Microbiology Laboratory, said that he has tremendous respect for those who work in public health and that it is an extremely difficult job.
That said, he continued, the Public Health Agency of Canada was created to better prepare the country for the next SARS. I think it is fair to say that we can understand that many had higher expectations.
I echo Dr. Gardam who said that even though Canada never became a New York or an Italy, things could have gone much better.
So, who has been giving advice, and has the government been taking it?
And will things go better if there are following waves of COVID-19 or another coronavirus?