Global Courant
A new series published in the medical journal BMJ calls for an independent investigation into Canada’s response to COVID-19.
Experts from 13 organizations across Canada, including doctors, nurses, researchers, lawyers and humanitarian specialists, along with Jocalyn Clark, a Canadian who is the international editor of the BMJ, wrote the seven articles published late Monday.
“We see this as the next step in the pandemic,” said Dr. Sharon Straus, chief physician at Toronto’s St. Michael’s Hospital and one of the senior authors of the “Accountability for Canada’s COVID-19 Response” series.
“This is the beginning of preparation for the next emergency,” she said.
The articles identify shortcomings in Canada’s COVID-19 response, including the difficulty of reaching vulnerable and marginalized populations most at risk, catastrophic deaths in long-term care homes, and inconsistent public health messaging across provinces and territories.
The articles also recognize successes in Canada’s pandemic response, including a vaccination rate of more than 80 percent.
“A review two years after the pandemic said the country had a lower COVID case and death rate and a higher vaccination rate than most other G10 countries,” the authors said in a BMJ editorial summarizing their findings.
“But this general impression of adequacy masks important disparities by region, setting and demographics.”
A series of articles previously published in the BMJ about the UK’s response to COVID-19 helped inform a study in that country, Straus said, so the authors hope the same will happen in Canada.
ESSENTIAL WORKERS AND MARGINALIZED COMMUNITIES
It’s important to take a close look at who bore “the burden of the pandemic,” Straus said.
Those people include essential workers who earn low wages and live in underserved neighborhoods, she said.
One of the lessons Straus hopes to learn from a study of the response to COVID-19 is how crucial it is to “build relationships with the communities most likely to be involved in these health inequalities before the next health emergency.”
Those relationships can ensure that marginalized communities are involved in research and that their needs are prioritized in reaching public health, she said.
FAILURE OF LONG-TERM CARE
An investigation is needed to ensure “accountability for losses,” including 53,000 deaths in Canada — many of them in long-term care, the authors said.
“A particular shame is that Canada tops rich countries for COVID-related deaths in care homes for the elderly, despite more than 100 reports heralding a nursing home crisis,” they wrote.
Those reports identified problems such as chronic underfunding in long-term care and a lack of adequate support for staff, Straus said.
Some provincial governments are already backtracking on some of the measures they have taken to bolster long-term care, she said, including sick pay for staff. Straus also noted the importance of ensuring care homes do not use the quadruple rooms where COVID-19 and other diseases can easily spread.
“We have a responsibility to those who have died to make sure we do better with them…so it doesn’t happen again. We don’t want to risk the lives of more older adults and those who care for them,” Straus said.
REGIONAL DIFFERENCES AND STAFF
A national study should also include recommendations for “reshaping Canada’s healthcare and public health systems, which were struggling before the pandemic and are currently on livelihoods,” the authors wrote.
COVID-19 resulted in “an exodus of exhausted and distressed healthcare workers,” they wrote, noting that Canada remains “critically understaffed.”
Canada’s decentralized healthcare system, with provinces and territories responsible for their own public health responses, has contributed to inconsistent COVID-19 messaging and guidance across the country, the BMJ articles said.
The Public Health Agency of Canada is developing “national clinical and public health guidelines” but “lacks the powers to direct provincial and territorial health agencies or other agencies with similar mandates to implement its recommendations,” they said.
“Each province and territory devised its own interventions and timelines for protective measures, such as school closures, border checks and closures, gathering bans and masking requirements, leading to significant differences in policy and practice across the country, widely varying hospital admissions, and public confusion.”
An important lesson from that, Straus said, is the need to be “explicit and transparent” about why there are different approaches in different regions.
Not being transparent about why public health decisions are made creates “distrust,” she said.
Exploring what went right and wrong in Canada’s COVID-19 response through an independent study is “essential,” the authors wrote.
“Not looking at the past ensures an unchanged future.
Undoubtedly, lessons can be learned to underpin new health investments and preparedness, and much learning comes from decisions and actions that failed or faltered,” they wrote.
When asked to respond to the call for a national survey and the issues raised by the BMJ series, Guillaume Bertrand, press secretary to Federal Health Minister Jean-Yves Duclos, said in an email that they are “committed to reviewing the response to COVID-19 to take stock of lessons learned and to better inform preparations and responses to future health emergencies.”
This report from The Canadian Press was first published on July 24, 2023.
Canadian Press health coverage is supported by a partnership with the Canadian Medical Association. CP is solely responsible for this content.
