New Brunswick will seek independent review of its COVID-19 pandemic response

New Brunswick will seek an independent review of its response to the COVID-19 pandemic.

"We are currently looking at options for government consideration," Erika Jutras, spokesperson for Finance and Treasury Board told CBC.

The decision comes as the province prepares to lift all COVID-19 restrictions Monday, just over two years since the province recorded its first confirmed case of the virus.

As of last month, departments have reported year-to-date COVID-19 expenses "exceeding $130 million," Jutras said.

She did not respond to questions about the purpose of the pandemic "post-mortem" or what it will entail.

But she did say it will be made public once its complete.

No timeline or estimated cost was provided.

It's unclear whether the government will publicly post an invitation for applications, as it did to fill the role of commissioner of systemic racism last year, or if it will appoint someone under the Inquiries Act, which provides specific powers, such as the ability to subpoena.

"We will have more details to share about the post-mortem once we are further along in the process," Jutras said.

Last December, the Liberals called for an independent review of the province's handling of the pandemic. Interim Liberal Leader Roger Melanson tabled the motion, saying it could help guide responses to future emergency responses.

"It's been a very difficult pandemic and there's been some decisions made good, and maybe been decisions made that were not as good, we don't know," he said. "There maybe have been situations where decisions should have been made and they were not made."

The motion was defeated 23-20 by the Progressive Conservative majority.

Premier Blaine Higgs told reporters at the time it was not the right time for a review.

"We are still dealing with issues related to [the] health and safety of citizens," he said.

"You may do reviews later and say, 'What would we do differently? How would you react differently?' But in the middle of a pandemic, you don't do a, basically a review or a study, that takes away from the resources that you need to deal with the issues at hand."

I thought this would be something that happens when all is said and done. And all is not said and done yet.- Raywat Deonandan, epidemiologist

Asked whether he would support the idea later, he said, "Sure," if the government feels it can "learn something," such as whether different actions could have had a better impact.

"Lessons learned are always helpful in analysis of past situations."

Higgs said he was proud of his government's response, citing spending to help businesses and people recover, record immigration, and interest in properties.

Raywat Deonandan, an epidemiologist and associate professor with faculty of health sciences University of Ottawa, calls New Brunswick's pending review both surprising and exciting.

"I'm surprised it's happening so soon. I thought this would be something that happens when all is said and done. And all is not said and done yet."

Still, Deonandan is pleased to hear New Brunswick is undertaking a review, and expects other provinces and countries will follow.

He believes the pandemic response as a whole actually requires a federal royal commission, much like the one held after the 2003 SARS (severe acute respiratory syndrome) epidemic and which resulted in the founding of the Public Health Agency of Canada.

Should cover 3 key things

But any review, including the New Brunswick one, should cover three key things, he said  — how decisions were made, whether they were rational, and how to "streamline the process for the next time around."

Determining whether decisions were made based upon the appropriate evidence will be "complicated," according to Deonandan, "because there's going to be a contingent of people arguing for evidence-based medicine."

Evidence-based medicine is the idea that the best quality evidence is used to make decisions around clinical care.

Some doctors argued there weren't randomized controlled trials for the efficacy of various measures used, such as masks and vaccine passports, he said.

"My pushback would be that public health emergencies require a different level of evidence. We don't have randomized trials for whether or not seatbelts work. We don't have randomized trials for whether or not smoking causes cancer. We make do with other kinds of evidence to make those kinds of decisions."

'Big questions'

More studies will ultimately be needed, though, to get "something resembling a final statement" on some of the "big questions," said Deonandan.

These include:

• Did school closures result in harm?
• If there was universal masking earlier on, could we have avoided restaurant closures?
• If we had mandated N95 masks instead of cloth masks, could we have avoided some of the economic restrictions seen in later waves?
• If we introduced a different method of prioritizing vaccination, could we have avoided the strain on the health-care system? 

"A number of questions need to be explored, and it's going to be interesting to see if they are explored and if the answers come out."

Whether some evidence was ignored should also be part of the review, said Deonandan.

He points out some people "were shouting" in 2020 that the coronavirus was an airborne virus and that some of the mitigation tools being applied, such as plexiglass barriers and hand-washing, were not appropriate.

"So one of the questions will be, was it sufficiently known by a sufficient number of experts, to a sufficient amount of confidence, that this was not the best way? … If that's the case, then some heads should roll."

Weaknesses

Weaknesses in the health-care system and Public Health's response should also be considered, said Deonandan. He cannot speak about New Brunswick specifically, but across the country, there is "a phenomenal amount" of weakness, he said.

There are problems with public health units reporting and communicating with the provincial and federal governments, for example, with some still using fax machines from the 1990s rather than email or more advanced methodologies. 

There is "very poor" testing capacity and vaccine rollout platforms that were "insufficient and poorly thought out," he said, suggesting mobile clinics could have started sooner and other ways to get vaccines to the most vulnerable could have been found despite the challenges of the need for refrigeration that led to some vaccine doses going to waste early on.

"So there are some efficiency issues that are low hanging fruit for exploration — and punishment, probably."

Deonandan hopes this review and others will result in more than just criticism for any failings though. He wants to see a "roadmap" for how to move forward and prepare for the "next big crisis because we're not done."

"So if a new variant emerges that compromises our vaccine efficacy, what's the plan?

"The problem with roadmaps is when the crisis actually comes, no one actually follows the roadmap, but at least having something in writing gives us a starting place for responding to the next crisis."