The report of the first inquiry into Canada’s handling of the COVID-19 pandemic opens with something of an epigraph, a quote from a report into the 2003 SARS outbreak: “A decade later, very similar recommendations are repeated in our report.”
That excerpt is a reference to a 1993 report on the HIV epidemic, whose authors called for increased surveillance and coordination, a national vaccine strategy and centralized data warehousing.
Now, in 2024, Canada has yet a third report on the threats posed by pandemic illnesses. And this country is at risk of yet again repeating the mistakes of the past because, as the inquiry’s chair Sir Mark Walport notes, “a future pandemic or other health emergency could be swifter and more severe, leaving no room for error.”
And while the public health emergency has passed, the COVID-19 pandemic is still very much here.
The events of the COVID-19 pandemic took the world by surprise. Recall the mass uncertainty and reaction to each new piece of information, as the country tuned in daily for government updates and panic-bought toilet paper. Imagine if there had been a handbook ahead of time. Actually, there’s no need to imagine – it’s already been written.
In 1993, Health Canada organized a study examining the HIV epidemic. The resulting report laid out recommendations to prepare for the next such crisis. In 2003, the National Advisory Committee on SARS and Public Health was convened and found that “there was much to learn from the outbreak of SARS in Canada – in large part because too many earlier lessons were ignored.” The findings from the 1993 study persisted. “Indeed,” the 2003 report says, “we essentially recapitulate many of them in this report.”
Here’s how the 2003 report summarizes that year’s events: “SARS killed 44 Canadians, caused illness in hundreds more, paralyzed a major segment of Ontario’s health care system for weeks, and saw in excess of 25,000 residents of the GTA placed in quarantine... The economic shocks have already been felt not only in the GTA, the epicentre of SARS, but across the country.”
It’s all there, the death, the mass illness, the strain on health care, the economic effects. Even the quarantines.
Yes, the scale may sound paltry compared to what unfolded during the COVID-19 pandemic, but it also eerily foreshadowed what was to come. And that report in 2003 lamented how the previous guidelines had been ignored.
The current inquiry is clear in its recommendations, split into four main groups: national health risk governance; science advisory mechanisms; health research prioritization, funding, and coordination; and health data availability and use. (This report deals only with the scientific approach to the pandemic, excluding such topics as vaccine strategies or strategic stores of personal protective equipment.)
In practice, this looks like a comprehensive and responsive national monitoring system, one that can be easily updated and changed according to the crisis at hand. Future pandemics need to be identified through continual “horizon scanning,” updating a national risk register. This register must be shared across the provinces and territories.
Next, there must be an on-call science advisory system. The interdisciplinary team should be largely independent and drawn from a predetermined roster, called up according to the nature of the crisis.
Third, emergency-related research across the country needs to be coordinated and in constant communication. The research networks established during moments of crisis need to be maintained during inter-emergency periods, as do granting councils and funding.
Finally, health data need to be uniform and centralized to maximize their usefulness and diagnose at-risk populations in real time.
These recommendations are not perfect and will present occasion for much debate – notably pertaining to civil liberties surrounding patient data that the inquiry says will be scrubbed of identifying characteristics to protect privacy.
Nor will they prevent the next pandemic. But they must be studied.
This report provides Canada an opportunity to take stock of the lessons learned from this most recent pandemic – and to implement them before they are forgotten all over again, to Canadians’ peril.