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Canada needs a pandemic post-mortem now, not later

It is impossible to blame anyone from the average Canadian to doctors and nurses to political leaders and health officials who would rather not think about COVID-19 ever again. But it would be an obvious mistake to not look back.

A Liberal MP's bill would launch a review and compel regular reporting on pandemic preparedness

Nicholas Ruder and his 3-year-old daughter Caroline Ruder wait as Jean Guo, a physician assistant, administers the Moderna Spikevax mRNA COVID-19 vaccine at an outdoor clinic at the East Lynn Park in Toronto on Aug. 12, 2022. (Sabah Rahman/CBC)

It would beunfair to blame anyone doctors and nurses,political leaders and health officials,average Canadians for wanting to neverthink about COVID-19 again. Even if the pandemic isn't actually over, the desire to move on is evident in every dropped restriction,every maskless face.

But it would be amistake to not look back. The enormous and fast-moving event thatconsumed the last two-and-a-half years of our lives posingprofound challenges to society, public policy and institutions practically cries out for careful, retrospective examination.

And we can be sure that there will be another viruseventually, another pandemic. It would betray the Canadians who face that threat to avoid learning the lessons of this pandemic.

Given the stakes, it's surprising that no royal commission or national study has been announced already. But later this fall,the House of Commons will consider at least one proposal this one from a Liberal backbencher to launch a review.

Nathaniel Erskine-Smith, centre, is proposing a deep review of Canada's pandemic response. (Adrian Wyld/The Canadian Press)

"I can understand that reviews like this can be politicized and every expenditure can be politicized. And that's really not my goal here," Liberal MP Nathaniel Erskine-Smith said in an interview this week.

"The goal is, let's learn the lessons for better and worse in order to inform our efforts going forward, so we are on the absolute best footing going forward to prevent future pandemics and to prepare for future pandemics."

The bill Erskine-Smith has tabledwould compel the health ministerto create an advisory committee that would pursue a potentially broad study of the response to the COVID-19 pandemic in Canada.

That committeewould review the actions of the Public Health Agency of Canada and the federal department of health. Italso would look at the responses of provincial and municipal governments and "analyze the health, economic and social factors relevant to the impact of the pandemic in Canada."

The many things a review could explore

There's a lot to investigate here.

COVID-19 has been, first and foremost,a health crisis with deadly consequences. But it also has testedpublic policy in many ways that were relatively novel (at least at this scale). And while it was tempting at times to saypolitical differences had been put aside during the pandemic, nearly every aspect of the public policy response eventually was second-guessed and criticized by one side or another.

To understand what worked and what failed and to settle some of those debates a truly comprehensive review would start with the state of pandemic preparedness in early 2020.

It would then move on to consider allthe public health issues that came to the fore in the weeks and months that followed: border controls, contact tracing, masking, public health restrictions on businesses and individuals, data collection, the procurement of personal protective equipment, rapid tests and vaccines, long-term care, federal-provincial coordination and the use of vaccine mandates.

But a proper study would look beyond the public health response to consider the unprecedented fiscal response, largely led by the federal government. The most recent official tally says the Liberal government spent $352 billion on supportsand assistance for individuals, businesses and provincial governments.

A proper study also wouldhave to explore how the pandemic intersected with race and wealth to expose and exacerbate inequality.

During last year's federal election campaign, the Conservatives said they would call "an immediate public inquiry to examine every aspect of the government's pandemic response." At the time, they were doubtlesseager to enumerate every shortcoming in the Liberals' handling of the crisis. But the Conservatives have not pressed the issue since.

The Liberals themselves have expressed some interest in the idea of a review. "We are open to an inquiry that is as deep as necessary,"then-health minister Patty Hajdu saidin April 2021.

In response to questions this week, the office of Health Minister Jean-Yves Duclos at least confirmed that the federal government still meansto pursue some kind of review, eventually.

"To better inform preparations and responses to future health emergencies, we know how important it is to take stock of the lessons learned through this pandemic. Some of this work is already underway through internal reviews by the Public Health Agency of Canada, in addition to external, independent reviews of [the Global Public Health Intelligence Network] and by the auditor general," Duclos's office said in a media statement.

"The government has committed to a COVID response review, and more information will be communicated in due time."

Looking forward and demanding accountability

But Erskine-Smith's bill envisionsmore than a backwards-looking exercise.

In addition to striking that advisory committee, the bill would give the health minister two years to draft a pandemic preparedness plan and would compel himto select an official at the Public Health Agency of Canada to serve as a "national pandemic prevention and preparedness coordinator." The official pandemic plan would have to be tabled in Parliament and then updated at least once every three years.

A first responder with Orange County Fire Rescue makes her way through floodwaters looking for residents in Orlando, Florida in the aftermath of Hurricane Ian. Climate change isn't just changing the weather it's changing the behaviour of disease outbreaks. (Phelan M. Ebenhack/The Associated Press)

Erskine-Smith took his inspiration not just from the pandemic we've all lived throughbut from international reports on climate change and biodiversity global warming is expected to make pandemics more likely.

"There was a consensus that we need to do more to prevent pandemic risk and to prepare for future pandemics," he said.

In calling for continued vigilance and regular reports to Parliament, the Liberal MP also took a cue from climate change accountability legislation that was passed into law last year. Ideally, that kind of future reporting might also ensure that the findings of a COVID-19 review don't merely take upspace on a bookshelf something that has happened to previous commissions, notwithstanding howwise and meticulous its authors were.

An ounce of prevention costs less than reaction

As with climate change, the value of proactive action is obvious.

Erskine-Smith recalled a briefing byWorld Bank officials several years ago about the risks of antimicrobial resistance and "superbugs." What those officials stressed, he said, was that the cost of prevention would pale in comparison to the cost of dealing with the impacts.

"That's, I think for me, the greatest lesson of the challenge that we just lived through ... the costs of prevention are a tiny fraction of the costs of a pandemic to society, both in its impact on human lives but also on our economies," Erskine-Smith said.

"As a matter of human health, as a matter of the strength of our economies, but also just as a matter of the fiscal ability of governments to respond, I think prevention and preparedness are so much more important than a reactive response."

COVID-19 is still with usand it might be years before Canadians fully reckon with all that the pandemic has wrought. Another pandemic isinevitable and the need to learn from this one isn't going away.