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Canada Government documents reveal a slow start to Canada's COVID-19 response

12:46  10 april  2020
12:46  10 april  2020 Source:   cbc.ca

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a person wearing a suit and tie: Early messages from bureaucrats to Health Minister Patty Hajdu never hinted at the eventual scope of the pandemic. © Sean Kilpatrick/The Canadian Press Early messages from bureaucrats to Health Minister Patty Hajdu never hinted at the eventual scope of the pandemic.

Briefing notes prepared by bureaucrats for federal ministers show just how quickly the COVID-19 situation evolved in Canada — with public health officials stating the risk of transmission in Canada was low right up until early March, only to recommend an ordered shutdown of economic life in this country some two weeks later.

Prime Minister Justin Trudeau warned Thursday that it could be as long as a year before normal life returns in Canada — a dramatic change in messaging, considering how Public Health Agency of Canada officials were advising policymakers less than two months ago that COVID-19 risks were low in this country, and that mandatory quarantines for returning travellers would be too difficult to enforce.

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A March 10 department-drafted briefing note prepared for Health Minister Patty Hajdu ahead of question period said that, with just 12 cases being reported nationwide at that point, "the risk of spread of this virus within Canada remains low at this time." The note also said the public health system is "well-equipped to contain cases coming from abroad, limiting the spread in Canada."

A month later, Canada has more than 21,000 cases.

As the documents show, as early as Jan. 28 the World Health Organization (WHO) was describing the risk of COVID-19 transmission as "very high" in China and "high at the global level."

The tranche of documents, prepared by various government departments and tabled with the Commons Health committee late Wednesday, include many of the early planning memos that informed the federal government's response to COVID-19 in January and February.

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They show that while the government was seized with repatriating Canadians from China's Hubei province and various cruise ships during that time, there was little talk of a possible pandemic.

Public health officials questioned the accuracy of media reports out of the city of Wuhan, in Hubei, suggesting that the virus was spreading through person-to-person contact.

"Based on the latest information that we have, there is no clear evidence that the virus is easily transmitted between people," a Jan. 19 briefing note prepared for Hajdu said.

The documents also reveal that the government was reluctant to strictly police travellers arriving from Hubei, the region of China where the novel coronavirus is thought to have originated.

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According to talking points prepared for a Jan. 30 call with her provincial and territorial counterparts, Hajdu said preventing the virus from arriving in Canada was "next to impossible" because of the nature of global travel.

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"What really counts is limiting its impact and controlling its spread once it gets here," the talking point reads.

Three days later, the U.S. barred all non-citizens coming from China from entering the country.

While there were information booths at major Canadian airports starting on January 21, the decision to collect personal contact information from inbound Hubei travellers was only made on Feb. 19 — information that could then be used by public health officials to follow up with people if an outbreak emerged.

The government relied on individuals to self-report to Canadian Border Services Agency (CBSA) officers if they were experiencing flu-like symptoms, long after temperature monitoring measures were commonplace at airports in Asia.

Between Jan. 22 and Feb. 18, 58,000 travellers arrived in Canada from China — 2,030 of them were coming from Hubei province.

Only 68 were pulled aside for further assessment by a quarantine officer and only three passengers were actually flagged for a medical exam — the other 65 passengers were sent away with a pamphlet.

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It's impossible to know how many pre-symptomatic and asymptomatic passengers were released into the general Canadian population.

Bureaucrats warn against mandatory quarantines

On Feb. 7, the government started recommending that inbound Hubei passengers start to voluntarily self-isolate for 14 days to prevent transmission.

In an undated memo to Hajdu sent in mid-February, department officials warned that Canadians may question the effectiveness of "voluntary" self-isolation measures for these travellers.

But the memo says "there is no ability to enforce or ensure compliance" with a mandatory isolation order without the use of the Quarantine Act — a measure the government would end up enacting weeks later.

The memo said it was best to leave all self-isolation measures as voluntary to ensure there is "less pressure on public health resources."

The memo said public health officials didn't have the capacity required to quarantine passengers from China; 20,000 such travellers were arriving in Canada each week at the time.

The Public Health Agency scrubbed any references to China in pamphlets disseminated to returning travelers starting on Feb. 24, after it was clear that there was community spread of COVID-19 in countries like Iran and Italy.

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Calls between Hajdu and her provincial and territorial counterparts later in February focused on quarantine facilities for returning Hubei and cruise ship travellers in Trenton and Belleville, but said little about how the various jurisdictions would respond if COVID-19 escalated.

According to briefing notes for a Feb. 10 call, Hajdu said that while the country was in a "containment phase, we cannot ignore what comes next."

The note states that the Public Health Agency of Canada was "doing advanced thinking and scenario analysis, including a pandemic scenario," but it's not clear if those scenarios were actually discussed with provinces and territories on that call.

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Health Canada expected Hajdu would be pressed by the provinces about the supply of personal protective equipment (PPE) on the call. The department told her then there were ongoing "attempts" to secure devices like N95 and surgical masks for the national stockpile but "deliveries were staggered by industry due to mounting market pressures."

It said it had procured only a "modest" amount of the masks — items that would be badly needed a month later.

By Feb. 26, when there were 78,000 COVID-19 cases in mainland China, public health officials continued to counsel Hajdu that "the public health risk within Canada remains low." A month later, there would be 1,000 cases in Ontario alone.

Even after the number of suspected COVID-19 cases in Canada started to rise by mid-February, Canada's National Microbiology Laboratory in Winnipeg did very few tests, with most of them reserved for travellers from China. It is now understood there was widespread transmission of the disease in Europe and in some U.S. hotspots like New York by this time.

By Feb. 17, the national lab had run only 461 tests — a marginal increase from the 367 tests run the week before.

By Feb. 25, Ontario and B.C. had provincial labs ready to test but the other provinces were still relying on sending samples to Winnipeg — a cumbersome process that made it difficult to identify and isolate cases in the other provinces early on.

Countries 'caught off guard': Trudeau

When asked Thursday what went wrong in the government's COVID-19 planning, Trudeau said there will be time for reflection at a later date. He said he was confident the government made the "best decisions" with "the information we have."

"I think we've seen countries around the world caught off guard by the nature of this epidemic," he said. "The challenges we faced in terms of getting Canadians protected are echoed in challenges faced around the world.

"I think Canada has done a good job of keeping on a path that is going to minimize as much as possible the reality we're in right now. As we look back at the end of this, I'm sure people will say, 'You could have done this a few days before.'"

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