Looking into the past: a public health perspective on COVID-19
by Yuan Chao (Tim) Xue, Science & Policy Exchange (SPE)
A public health emergency is an “urgent and critical situation of a temporary nature that seriously endangers the lives, health and/or safety of the population”.
These situations include Hurricane Katrina, the 2009 H1N1 pandemic, and the recent COVID-19 outbreak. Since it is important to learn from the past in order to become better prepared and put forth appropriate recommendations, public health researchers and officials often look into the past and critically evaluate actions taken.
As outlined by an advocacy statement by the Canadian Public Health Association, Canada’s COVID-19 pandemic response and recovery plans aim to minimize life-threatening illnesses and death while limiting potential societal disruptions to Canadians. The federal government’s responses to any public health emergencies include surveillance, guidance development, testing, provision of emergency supplies, and quarantine initiatives. While most of these responses were successful during the initial COVID-19 wave, the Canadian government lacked in areas such as data collection and testing capacity, resulting in approximately 4.2 million confirmed cases and over 44,000 deaths (as of September 2, 2022).
Data Collection Capacity
Each province or territory is responsible for collecting clinical and public health information, while the federal government’s role in the public health system is limited. During the COVID-19 pandemic, the inconsistent and delayed data delivery (one of the characteristics of the lack of centralized health service) limited the capacity of the public health agencies to reduce the health inequalities among those most affected or at risk, such as the LGBTQ+ populations, indigenous communities, low socioeconomic status individuals and visible minority ethnical groups.
Diagnostic Testing Capability
While testing guidelines were quickly developed by each province and territory, many still experienced significant delays in diagnosis and testing. This is mainly due to the unprecedented magnitude of the cases, a shortage of testing kits and reagents (likely due to supply chain disruption), a delay in planning for conducting further testing, and limited analytical capacity in each province and territory. This delay led to many provinces and territories redirecting their focus to those who were symptomatically ill, with limited testing provisions for those without symptoms, both of which led to the spreading of the virus. Ultimately, this shift in focus likely underestimated the case load and spread of the virus during each wave in Canada.
It is vital that public health researchers and officials re-examine the actions not only of themselves but other countries so that the public health responses to any future emergencies can be improved. Researchers from the University of Saskatchewan recommend a more centralized public health system as demonstrated by Singapore and South Korea during the initial outbreaks.
In addition, it is recommended by the Canadian Public Health Association for the federal government to collaborate with the provinces and territories to develop standardized national data collection guidelines in order to improve local, regional, and provincial data collection capacities, and foster a national framework for improved surveillance capacities within Canada.