Changes to pandemic watch urged
Canada’s international surveillance
OTTAWA • An independent panel is recommending Canada overhaul its international surveillance system for public health issues, giving it the tools to better spot the difference between a mild, local outbreak and a looming global pandemic.
Health Minister Patty Hajdu commissioned a panel last year to look at the Global Public Health Intelligence Network (GPHIN), which has existed inside Health Canada and the Public Health Agency of Canada (PHAC) since the mid 1990s.
GPHIN scans more than 7,000 news articles and other public sources every day across nine languages to look for potential public health risks anywhere in the world. It has been considered a world-leading service and has previously identified the early signs of several disease outbreaks. In addition to daily reports, it issues alerts when it finds something particularly concerning that demands more immediate attention.
The team behind GPHIN first noticed reports of what would become COVID on Dec. 30, 2019, and put information out about the troubling, unexplained virus the next day. The independent panel made up of public health experts, Margaret Bloodworth, Dr. Mylaine Breton and Dr. Paul Gully, found PHAC could not have detected the virus earlier.
“The panel has seen no evidence suggesting that earlier identification by GPHIN of the outbreak would have been possible.”
Hajdu was not available for an interview Monday, but in a statement thanked the panel for the report and said the government would do everything possible to learn the lessons from COVID-19.
“This independent review was initiated to identify what changes are required to keep Canada well positioned to detect and respond to future public health events,” she said. “It is critical that the lessons learned from our response to the pandemic help improve the tools in place to protect Canadians.”
Conservative Health Critic MP Michelle Rempel Garner said the panel report is another example of the government’s lack of preparedness.
“These failures led to lost lives and the countless consequences of the pandemic. That’s why Conservatives have put forward Canada’s Emergency Preparedness Plan that will secure our future and ensure Canada is ready to face future pandemics.”
While the expert panel found GPHIN had identified COVID appropriately, they did find a need for a better approach to risk assessment at PHAC that can identify the fires among all the smoke that emerges every day.
They said the GPHIN team is impressive and world-leading, but it is unclear who is supposed to triage the information to determine the real threats.
“It is not always clear who is responsible for what in the flow of information, risk assessment and chain of decision-making,” they wrote.
A chief health surveillance officer position that could have helped with the information and risk-assessment was left vacant in 2017.
The panel found that without a dedicated risk-assessment team, the work of deciding what is and isn’t a major problem falls to the chief public health officer without any clear standards.
“Currently, the responsibility for risk assessment appears to reside with the (chief public health officer), though legislation is not clear on this point,” the panel wrote. “Also, there is no dedicated team to coordinate assessments carried out across the many program areas.”
They said a dedicated group inside PHAC looking at risk assessments could also work with national security agencies that might have information on public health threats.
“The risk assessment office could also help establish stronger links in general to the national security community that can go beyond the strict exchange of intelligence.”
The agency has previously been criticized for not issuing a specific GPHIN alert about COVID and leaving it buried inside a routine daily report. The daily reports go mostly to a Canadian audience, while the alerts are sent wider with more than half the mailing list belonging to international readers including many people at the World Health Organization.
The number of alerts declined in recent years and the review found a bureaucratic reluctance to alerts because bureaucrats overseeing the GPHIN program didn’t fully understand them.
“The panel has heard on several occasions that some senior leaders were concerned about alerts being interpreted as official Government of Canada positions on events happening internationally or that some alerts may have been premature or unnecessary.”
The panellists said GPHIN is a world-leading system and Canada should continue to share information with the world. They said analysts should be encouraged to work with the peers in other countries and that GPHIN should expand its subscriber list to international groups.
“One of the surest ways to protect Canadians from pandemics is to support the international community to identify and address events before they are out of control.”
The budget for the GPHIN program has remained consistent at between $2.5 million and $3 million over the last decade, but the panel found some key positions had been removed including a technical adviser who was dedicated to the system.
The panellists found that position should be restored to leave the analysts to focus on health issues instead of having to act as technical support. They said it is important Canada learn from the lessons of COVID, because there will be other outbreaks.
“The question is not whether another pandemic will strike but when. Every day, Canada’s ability to respond and manage a pandemic is being tested and recast,” they said. “But the measure of what Canadians have learned will be not only our response to the next pandemic but also how we will mitigate future threats through earlier detection and coordinated international action.”