Canada's pandemic warning system was understaffed and unready when COVID hit, review finds

An important position at the Public Health Agency of Canada (PHAC) was vacant and the country's pandemic early warning system was understaffed when the COVID-19 pandemic struck, an independent panel has found.

The final report on what went wrong at that key moment with the Global Public Health Intelligence Network (GPHIN) — a multilingual monitoring system that scours the internet for reports of infectious diseases — was released today.

The report says that, among other things, surveillance was not well co-ordinated in the four years leading up to the arrival of the novel coronavirus, a problem the report says was partly due to the fact that a key position — chief health surveillance officer — had been left vacant since 2017 and was due to be eliminated.

Health Minister Patty Hajdu ordered the independent review in response to claims by some scientists within the government that their early warnings about the threat of COVID-19 were ignored or inadequately addressed by senior PHAC staff.

The three-person panel — former national security adviser Margaret Bloodworth and health experts Dr. Paul Gully and Dr. Mylaine Breton — found that while PHAC had drafted a strategic surveillance plan in 2016 for detecting pandemics,  "the plan never received formal approval."

The report says the Internet-based GPHIN surveillance system had experienced a turnover in critical staff and the network had never regained the positions cut in the course of the former Conservative government's deficit-reduction action plan.

The findings build upon those of a preliminary report, released in March, that found the system for issuing public health alerts at GPHIN is lacking.

No explanation for change to pandemic alert system

The early warning system issued a daily internal report but not a more significant alert about the emergence of COVID-19 in Wuhan, China, on December 31, 2019.

In 2019, authority to issue alerts was taken away from the GPHIN team and vested with the vice-president of the agency. The panel pointed out in its interim assessment that it had not been given any explanation for the change to the system for issuing alerts.

The question of who ordered this significant policy change was never answered.

"The Panel has not seen any documentation that could be considered formal direction on changing the Alert approval process," the final report says.

"However, we have reviewed emails from early April 2019 that were exchanged among GPHIN analysts and managers that refer to the pending change and discuss how it might be implemented."

It is not clear why the independent review was never given an explanation for the dearth of evidence about the policy change, whether records existed or whether they had been withheld.

In a statement, Hajdu thanked the panel for their recommendations but did not say how many of them would be acted upon. The minister said only that "it is critical that the lessons learned from our response to the pandemic help improve the tools in place to protect Canadians."

The Conservative opposition said the promise to learn lessons needs to backed up with specifics and the review panel simply adds to a litany of reports on how the system failed Canadians. 

"This scathing report shows once again the Liberal government was unprepared for the COVID-19 pandemic," said Michelle Rempel Garner, the Conservative health critic. "These failures lead to lost lives and the countless consequences of the pandemic." 

Last spring, Auditor General Karen Hogan issued a highly critical report on the Liberal government's handling of GPHIN.

In 2019, the federal government ordered the once-world class intelligence network to focus its attention more on domestic surveillance than on international outbreaks, the auditor reported.

Since the decision to transfer the power to issue alerts from the GPHIN to the vice-president of the agency was the focus of both a Globe and Mail investigation and criticism by the auditor general, a clear protocol has now been issued and the authority to make decisions about alerts has been delegated back to "the appropriate level," the independent panel's report says.

But "the corrosive effect of this decision, and how it was carried out, is still apparent," the report adds.

Senior leaders fretted about optics: report

The closest the panel got to an explanation for this decision was the observation that senior leadership overseeing GPHIN — mostly people with no public health background — were worried about optics.

"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 report says.

"These are valid concerns to raise. But, in isolation, this confusion should not be the premise upon which PHAC alters its approach to international surveillance."

The panel makes a number of recommendations aimed at improving GPHIN — including a call for clearer mandate, better technology and more collaboration with private sector partners controlling sophisticated health surveillance systems.

Wesley Wark, a University of Ottawa professor and one of the country's leading experts on intelligence systems, said he was happy to see the report did not simply dwell on the failures.

One element that was missing, he said, was an attempt to answer nagging questions about how a world-class system could have been allowed to deteriorate.

"What the report fails to get at is the underlying cultural question and problem — why did PHAC allow the vision to GPHIN to slip away?" Wark said. "The most obvious answer is a growing indifference to the idea that Canada could play a global leadership role with regard to health intelligence and surveillance." 

It is "that cultural problem that PHAC will have to course-correct if all the other fixes to GPHIN are to have any real significance," he added.

Pandemic monitoring a 'fundamental responsibility of government'

Despite the temptation to "outsource" the network, the panel says, pandemic surveillance must be a core function of government.

"The Panel believes that public health surveillance is a fundamental responsibility of government, and that PHAC in particular must retain the ability to collect and use all types of surveillance data in order to protect Canadians' health. As such, we believe that GPHIN should not be outsourced in its entirety," the report says.

The public health agency already has embarked on an internal reorganization.

CBC News reported in late spring that PHAC has shaken up its internal divisions and assembled a security and intelligence section tasked with providing better, faster warnings of future pandemics.

Government sources with knowledge of the file said the pandemic led to an influx of new personnel and resources, making it necessary to revamp PHAC's organizational structure. 

CBC News did not identify the confidential sources because they were not authorized to speak publicly.

CBC News sent PHAC a series of detailed questions at the time. While officials confirmed the reorganization, they refused to provide details on how the security and intelligence team will be organized and whether it will include GPHIN.