Peter Singer is a professor emeritus at the University of Toronto, and served as special adviser to the director-general of the World Health Organization from 2017 to 2023.
COVID-19 was the worst public health emergency to hit the world in a century. So, learning our lessons and implementing improvements in how we deal with such an emergency in the future is a matter of national security, pandemic fatigue notwithstanding.
To this end, this month the federal government released the Walport report, written by an expert panel for the “Review of the Federal Approach to Pandemic Science Advice and Research Co-ordination.” The panel was led by Sir Mark Walport, a renowned medical scientist and the current joint foreign secretary of the Royal Society (Britain’s independent scientific academy). He previously served as the chief executive of UK Research and Innovation, which directs science research funding in Great Britain. I knew Dr. Walport when we served on the scientific advisory board of the Gates Foundation’s Grand Challenges initiative, which grants funding to projects that solve global health problems. He is smart, evidence-based, and precise, and his panel has outstanding people on it.
This is an excellent report, and its 12 recommendations suggest improvements for Canada’s future pandemic response, categorized into four primary themes: risk, science advice, research co-ordination, and data. It does not directly cover the high-profile issues that grabbed headlines during the pandemic, like vaccine distribution, infection response in nursing homes, lockdowns, and travel restrictions (though the future handling of these and other issues would be better if the panel’s recommendations became reality). Instead, the report largely focuses on how we gather and use information, and how to make better public health decisions with it. It’s a bit like renovating a house: installing plumbing and electricity isn’t nearly as exciting as the decor decisions, but if those foundational items are not working, your toilets back up, the power doesn’t work, and the house becomes unlivable.
We can only hope that the Canadian government takes the less exciting themes of the Walport report seriously, and implements changes accordingly. After all, Canada has a long tradition of commissioning excellent reports on important subjects from thoughtful panels, only to have those reports sit on a shelf and gather dust. To really make use of the Walport report, the government needs to commit to the recommended measures while also being specific in how much these improvements will cost and how long it will take to implement them, while publicly reporting on its progress.
One of the most valuable recommendations in the Walport report would reinforce the effectiveness of both our pandemic response and primary health care in Canada, which is to “resolve the longstanding issue of the non-availability and fragmentation of essential public health and clinical data.” For example, as the report notes, pandemic measures that have since ceased to be a priority, such as vaccine registries, would be valuable outside of public health emergencies as well “for their potential to capture accurate and precise information on the distribution, uptake, and effectiveness of vaccines at both the individual and population level.”
One element missing from the report I would have liked to see is the measurement of Canada’s pandemic preparedness. It’s not enough to just assess risk – you also need to know how ready you are to deal with it. We learned during the pandemic response that static measures of preparedness (like the number of testing labs we have, etc.) were necessary but not sufficient measures of how prepared countries were to weather a virus like COVID-19. In addition, pandemic preparedness needs to include dynamic measures (for example, benchmarks of the time needed to detect an outbreak, report it, and respond to it) and continuous testing to see how often these benchmarks are being met.
COVID-19 also taught us that pandemics are where health, industry and national security policies intersect. On the national security side of the equation, if we are willing to invest in a standing army in peacetime, we also need to think about pandemic preparedness in a similar way. The Toronto-based digital health company BlueDot did very well at predicting the early spread of COVID-19. Imagine taking Canada’s scientific capacity in AI (see: the recent announcement of Geoffrey Hinton as a winner of the Nobel Prize) and not only applying it against the problem of pandemics, but also making sure it energizes companies like BlueDot and others. We could deal with our productivity problem while also improving our pandemic preparedness.
In the end, converting recommendations in even the best report into real-world impacts is about three things: implementation, implementation and implementation. The government now has an opportunity to accept these recommendations and implement them. If they do so, several steps should follow, including ongoing public reporting of the implementation’s progress. If they don’t, that tells us all we need to know.