Bureaucracy mars public health tool
EXPERT PANEL SAYS CANADA'S VALUABLE DISEASE SURVEILLANCE SYSTEM MISMANAGED
Senior managers put in charge of Canada's world leading public health surveillance system didn't seem to understand the value of the tool they had, according to an interim report.
Health Minister Patty Hajdu set up a three-person panel to review the government's use of the Global Public Health Intelligence Network (GPHIN). Media reports earlier this year revealed the system had been downgraded in recent years, issuing fewer alerts about disease outbreaks and was being restrained by an overly bureaucratic system.
The network is an event-based surveillance (EBS) tool, first set up in the 1990s, that scans media reports in multiple languages looking for signs of a disease outbreak.
GPHIN got a boost in the early 2000s after the SARS crisis and was considered a world leader in detecting new disease, having seen some of the first signs of the H1N1 crisis and the Zika virus.
In an interim report, the panel found the system is valuable and unlike any in the world.
“While there are now several open-source EBS systems operating publicly and privately, GPHIN is the only state-owned moderated system in the world,” reads the interim report.
The system is split between two primary focuses: a daily roundup of news articles and other details of possible infectious diseases, and an alert system for particularly concerning disease outbreaks that the international community should be concerned about.
Those alerts had to go through senior management approval before being sent out and the panel found some senior managers didn't seem to understand why they were valuable.
“The panel has also heard from some senior management directly overseeing GPHIN who could not describe the purpose or audience for alerts, and may not have had a complete understanding of their intent,” reads the report.
They also found it is clear someone inside government decided to downgrade the alert process, but they can't find any indication yet as to who made that decision or why they did it.
“The panel has not seen any written documentation in respect to the timeline of those changes, who requested them and why they might have occurred.”
The panel has until May to release a final report on the system, but this interim report has already found problems they intend to address.
“The panel will also be carefully considering the operational context for GPHIN based on findings to date, which confirm a high degree of management turnover, a decline in the number of internal experts with public health credentials.”
While the panel has found issues, the interim report said they don't believe it could have provided an earlier warning to the government or the world about COVID-19.
“The panel has seen no evidence suggesting that earlier identification by GPHIN of the outbreak would have been possible,” they wrote. “Canada's response to COVID-19 effectively began on the first day of 2020, in part due to event identification and notification of the initial signal by GPHIN staff.”
Conservative health critic Michelle Rempel Garner said the interim report suggests the government was slow to act in response to the threat of COVID-19.
“This is another indication of the fact that I really don't think the government took the pandemic as seriously as they could have in the first critical months of the pandemic.” she said.
The report details the government ramped up an operations centre to respond to the crisis, but didn't do so until Jan. 20 and even then only brought the situation up to its second highest alert level.
Rempel Garner said the report, along with a host of other government decisions around rapid tests and vaccines, indicates a far too bureaucratic response to the pandemic.
“Across different levels of responses the processes have been overly bureaucratized and I think that that has left us slow to react,” she said.
In a statement, Hajdu said the report is a good step toward understanding how the system was used and she said she looks forward to the panel's final report.
“Our government initiated this independent review to identify what changes are required to keep Canada well positioned to detect and respond to future public health events,” she said. “While the panel notes in its interim report the role GPHIN staff played in Canada's early response to COVID-19, it also raises important questions on how this system could and should operate.”