Canada's Chief Public Health Officer Dr. Theresa Tam attends a news conference as efforts continue to help slow the spread of coronavirus disease (COVID-19) in Ottawa, Ontario, Canada March 23, 2020.Blair Gable/Reuters
Canada’s Chief Public Health Officer said she supports an independent review of the country’s pandemic early warning system, and pledged to back government scientists who say their voices were increasingly being ignored and marginalized within the department.
“I think management has to be able to address any concerns from our scientists,” Theresa Tam told a press conference in Ottawa Tuesday. “Any difficulties of public servants, or our staff, in expressing their views and their concerns has to be taken really seriously.”
In light of a Globe and Mail investigation, Health Minister Patty Hajdu has ordered an independent review into the oversight of the Global Public Health Information Network, known as GPHIN, as well as concerns raised by scientists within the Public Health Agency of Canada (PHAC).
GPHIN served for decades as an early warning and intelligence-gathering system for health threats such as the COVID-19 outbreak. However, a Globe and Mail investigation in July found that key aspects of GPHIN’s functions were either shut down or curtailed in early 2019, less than a year before the COVID-19 pandemic began.
Several of the highly specialized doctors and epidemiologists, whose job was to scour the world for signs of deadly outbreaks, were shifted to work that wasn’t related to pandemic preparedness, amid shifting department priorities. And in May, 2019, an alert system designed to keep tabs on potentially catastrophic health threats fell silent.
Ms. Hajdu said she was troubled by statements from scientists within Public Health who told The Globe that their voices were sometimes being ignored by managers who lacked a background in science. Several past and present employees, some of whom The Globe is not identifying because they feared punishment for speaking out, said it became difficult to convey critical information up the chain of command. The problems extended beyond GPHIN into the agency itself, due to restructuring that took place over the past six to eight years.
“There’s a massive lack of understanding by the people working in the agency about the basics of health. What you present up the chain has to be dumbed down,” Michael Garner, an epidemiologist who spent 13 years at Public Health and was a senior science adviser before leaving last fall, said in a previous interview. “But some of these things are complicated. Having to simplify it down just doesn’t work."
Ms. Hajdu said her office is now in the process of determining candidates to lead the review.
Dr. Tam said she hoped the independent review will strengthen Canada’s early warning capacity. “We will address any findings and recommendations accordingly,” she said.
Before it was curtailed, GPHIN was responsible for one-fifth of the “epidemiological intelligence” used by the World Health Organization, and was called a “cornerstone” of Canada’s pandemic preparedness. The Globe obtained 10 years' worth of records that show GPHIN issued more than 1,500 alerts over the past decade, which helped the government monitor and prioritize potential health threats.
But officials within Public Health effectively shut that function down in late 2018, by preventing scientists from issuing alerts without senior management approval. With no clearance to issue alerts, the system soon went quiet. As a result, most of GPHIN’s surveillance and intelligence gathering also stopped.
“From my perspective, it’s very important to have as minimal of a delay, and minimal number of layers of bureaucracy, in a system which is meant to provide early alerting," Dr. Tam said.
Created in the 1990s as an experiment, GPHIN gathered clues from medical data, news outlets, social media, internet blogs and sometimes obscure sources such as financial reports to detect signs of outbreaks, particularly in countries that may not disclose them.
GPHIN once flagged a hidden outbreak of swine flu after noticing fluctuations in the price of hog futures in certain countries. And in 1998, the analysts noticed that a pharmaceutical company in China was reporting unprecedented sales of antiviral drugs in one particular region, for no apparent reason. That led to the discovery of the first SARS outbreak, which China had failed to disclose.
Dr. Tam and deputy chief public health officer Howard Njoo said they were informed of the outbreak of COVID-19 in China by a GPHIN e-mail on Dec. 31 and Jan. 1, which referenced a newspaper report on the outbreak in Wuhan.
However, Wesley Wark, an adjunct professor at the University of Ottawa who is an expert on intelligence gathering, said that is not how GPHIN was designed to work. The operation was created to gather intelligence and provide analysis that would inform the department’s risk analysis of a potential outbreak. That aspect has failed terribly in this outbreak, said Prof. Wark, who is working with the Auditor-General on a parallel investigation into the failings of Canada’s pandemic early warning system.
He said the government lacked good intelligence on the outbreak in January and February, which could have allowed it to act faster and better prepare. A fully functioning GPHIN was intended to serve this purpose, and potentially detect signs of a problem in China much earlier than Dec. 31.
Instead, throughout January, February and much of March, the government determined that the virus posed minimal risk to Canada. Public Health repeatedly classified the threat from the virus as “Low," according to the department’s risk assessments. That, in turn, affected key decisions, such as when to implement border closings, physical distancing as well as lockdowns at long-term care homes, which critics argue came much too late.
“The risk assessments [produced by Public Health] were not risk assessments in any professional sense of the word,” Mr. Wark said. “They were not looking at the risk COVID-19 presented to Canada and Canadian interests. What they were doing instead was simply keeping tabs on the extent to which COVID had made an appearance in Canada."
He said any examination of GPHIN’s problems must include a broader investigation into why Public Health’s risk assessments failed to raise alarms. “The system Canada created wasn’t working as it’s supposed to work,” Mr. Wark said.
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