A passenger walks past a notice for passengers from Wuhan, China, displayed near a quarantine station at Narita airport on Jan. 17, 2020 in Narita, Japan.Tomohiro Ohsumi/Getty Images
An independent review probing the mishandling of Canada’s pandemic early warning system has found senior management lacked an understanding of how the operation was supposed to work, which led to the silencing of its alert functions less than a year before COVID-19.
The review was ordered by Health Minister Patty Hajdu in September, after a Globe and Mail investigation showed the internationally respected system, known as the Global Public Health Intelligence Network, or GPHIN, had its operations curtailed before the pandemic.
In an interim report detailing their early findings, the three-member panel said their probe has “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.”
COVID-19 news: Updates and essential resources about the pandemic
COVID-19 is caused by a virus called SARS-CoV-2, and as it spread around the world, it mutated into new forms that are more quickly and easily transmitted through small water droplets in the air. Canadian health officials are most worried about variants that can slip past human immune systems because of a different shape in the spiky protein that latches onto our cells. The bigger fear is that future mutations could be vaccine-resistant, which would make it necessary to tweak existing drugs or develop a new “multivalent” vaccine that works against many types, which could take months or years.
Not all variants are considered equal threats: Only those proven to be more contagious or resistant to physical-distancing measures are considered by the World Health Organization to be “variants of concern.” Five of these been found in Canada so far. The WHO refers to them by a sequence of letters and numbers known as Pango nomenclature, but in May of 2021, it also assigned them Greek letters that experts felt would be easier to remember.
ALPHA (B.1.1.7)
- Country of origin: Britain
- Traits: Pfizer-BioNTech and Moderna vaccines are still mostly effective against it, studies suggest, but for full protection, the booster is essential: With only a first dose, the effectiveness is only about 66 per cent.
- Spread in Canada: First detected in Ontario’s Durham Region in December. It is now Canada’s most common variant type. Every province has had at least one case; Ontario, Quebec and the western provinces have had thousands.
BETA (B.1.351)
- Country of origin: South Africa
- Traits: Some vaccines (including Pfizer’s and Oxford-AstraZeneca’s) appear to be less effective but researchers are still trying to learn more and make sure future versions of their drugs can be modified to fight it.
- Spread in Canada: First case recorded in Mississauga in February. All but a few provinces have had at least one case, but nowhere near as many as B.1.1.7.
GAMMA (P.1)
- Country of origin: Brazil
- Traits: Potentially able to reinfect people who’ve recovered from COVID-19.
- Spread in Canada: B.C. has had hundreds of cases, the largest known concentration of P.1 outside Brazil. More outbreaks have been detected in Ontario and the Prairies.
DELTA (B.1.617 AND B.1.617.2)
- Country of origin: India
- Traits: Spreads more easily. Single-dosed people are less protected against it than those with both vaccine doses.
- Spread in Canada: All but a few provinces have recorded cases, but B.C.’s total has been the largest so far.
LAMBDA (C.37)
- Country of origin: Peru
- Traits: Spreads more easily. Health officials had been monitoring it since last August, but the WHO only designated it a variant of concern in June of 2021.
- Spread in Canada: A handful of travel-related cases were first detected in early July.
If I’m sick, how do I know whether I have a variant?
Health officials need to genetically sequence test samples to see whether it’s the regular virus or a variant, and not everyone’s sample will get screened. It’s safe to assume that, whatever the official variant tallies are in your province, the real numbers are higher. But for your purposes, it doesn’t matter whether you contract a variant or not: Act as though you’re highly contagious, and that you have been since before your symptoms appeared (remember, COVID-19 can be spread asymptomatically). Self-isolate for two weeks. If you have the COVID Alert app, use it to report your test result so others who may have been exposed to you will know to take precautions.
Need more answers? Email audience@globeandmail.com
Canada vaccine tracker: How many COVID-19 doses have been administered so far?
The review panel consists of Mylaine Breton and Paul Gully, whose backgrounds are in health policy and public health, and Margaret Bloodworth, who has a background in national security.
GPHIN was created in the 1990s to scan the world for early signals of health threats, scouring the internet, news feeds and other databases for hints of outbreaks that would allow Canada and its allies to respond quickly and prepare for a crisis. The system became increasingly sophisticated over time, using artificial intelligence and human analysis to track health threats, and supplied the World Health Organization with 20 per cent of its epidemiological intelligence.
However, The Globe obtained 10 years of internal Public Health Agency of Canada data last summer that showed GPHIN’s outbreak alert system was abruptly silenced in May, 2019, as resources were shifted to other areas of the department. With seemingly no pandemic threats on the horizon, some analysts were told to focus on domestic projects rather than international surveillance.
The interim report said the decision came from inside the department, which had no standard operating procedures in place for how the alert system should operate. Such procedures weren’t created until late 2020, after The Globe’s investigation was published and the system was restarted.
“It is clear that some form of direction was given to pause the alert process,” the panel said. “Prior to fall 2020, there were no written procedures governing the issuance of alerts.”
The Globe obtained a copy of the interim report, dated Feb. 26. A final report is expected in May. In a sign of the oversight problems at GPHIN, the report said in one case, “an alert was not issued at the direction of the director-general, but no rationale was provided.”
However, the interim report contains gaps in information. While the document confirms much of The Globe’s investigative findings – such as the rapid deterioration of alerts over the past several years, and that GPHIN was no longer the 24/7 operation the department claimed it was – the panel said it has “not seen any written documentation in respect to the timeline of those changes, who requested them and why they might have occurred.”
The Globe obtained several internal documents last year showing the genesis of those decisions, including an e-mail sent on Sept. 4, 2019, from Susanna Ogunnaike-Cooke, an assistant director, to colleagues at Public Health. The e-mail explained changes to the system set out by Jim Harris, who was director-general of the Centre for Emergency Preparedness and Response at the time, and Sally Thornton, then-vice-president of the Health Security Infrastructure Branch.
It is not clear why the independent review has been unable to obtain such evidence, whether records have been withheld or deleted. Both Mr. Harris and Ms. Thornton have since left the department. At the time, the restructuring of GPHIN alarmed officials at the World Health Organization, who saw it as a weakening of Canada’s pandemic preparedness infrastructure.
The interim report confirms GPHIN learned of the outbreak of novel coronavirus after a similar U.S.-based disease-tracking system called ProMed picked up on warnings posted inside hospitals in Wuhan, China, on Dec. 30, 2019. However, the report appears to echo the government’s stated position that Public Health spotted the problem at its earliest possible stage and acted quickly. In its conclusion, the panel posits that it could not find evidence that earlier identification of the outbreak would have been possible, which has been the department’s position, despite objections from its own scientists who dispute that notion.
However, the panel does not say what research it conducted to arrive at this determination. Intelligence experts told The Globe last year it is a mistake for the government to view the emergence of the outbreak at the end of December, 2019, when it suddenly made international news headlines, as the earliest possible sign of a problem. The actual outbreak would have emerged earlier.
With GPHIN not operating at full capacity, the system can’t know what it didn’t see in the final months of 2019, because it wasn’t watching as closely as it once did. In addition to GPHIN, Public Health once employed a doctor based in China who could report back on emerging concerns on the ground. But Canada had largely abandoned such international strategies over the past five years.
China has since been found to have played down the outbreak at its earliest stages, muzzling doctors and erasing criticism from the internet. But GPHIN was intended for more than just early detection; it also informed Canada’s risk assessments on outbreaks such as H1N1, Ebola and Zika as they worsened. However, throughout January, February and well into March of 2020, Canada rated COVID-19 as a low risk to Canadians, even after the WHO elevated its risk levels.
Ms. Hajdu has said she is concerned about issues scientists in the department raised about not having their voices heard by senior management, and about ensuring GPHIN can operate effectively. The panel’s final report in May will make recommendations about GPHIN’s future. COVID-19 has shone a light on the value of such systems. In the U.S., the Biden administration is moving to create its own government-operated pandemic early warning capacity similar to GPHIN. An independent panel commissioned by the World Health Organization to investigate weaknesses in the global response to COVID-19 is also issuing a report in May that will call on governments to bolster their pandemic early warning systems.
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