Public Accounts Committee on April 20th, 2021

[Karen Hogan]

To understand the Global Public Health Intelligence Network, I would highlight that it does two things: It issues alerts and it issues daily reports. A daily report was issued at the end of December that contained links to an article about a virus that would eventually become known as the virus causing COVID-19, and that did trigger a response within the Public Health Agency of Canada.

However, an alert, which I think is very different from a daily report, is something that makes you pause, stop what you're doing, go investigate and decide what response is needed. That was an issue. The criteria within the agency would have required that an alert be issued in this instance, and it's unclear why one didn't get issued. We saw it issued in the past.

What we did see is that in 2018, there were some changes to operating procedures within the agency about who would approve the issuance of an alert, from analysts to senior managers, and it appears that this caused some confusion about when an alert should be issued, if it should be issued. We did note throughout the audit that alerts were issued for other matters.

I think it's up to the agency now to decide what the Global Public Health Intelligence Network is needed for, to make it clear and then to use it as intended.

[Len Webber, Conservative, Calgary Confederation, AB]

Again, who made the decision to shut it down at that time?

[Karen Hogan]

Unfortunately, that's a question you'll have to ask the deputy minister of the agency. I just know that the approval rating changed and we saw a substantial decline in the issuance of alerts. It's important because an alert is not just a domestic issuance; it's also an international issuance. I think the agency would be best placed to answer that.

[Len Webber, Conservative, Calgary Confederation, AB]

Did Canada consult at all with the World Health Organization or our allies about shutting down GPHIN?

[Karen Hogan]

Again, that's a great question for the agency. What we saw during our audit was that the World Health Organization and our international counterparts had not been alerted that there was a change in the operating procedures that would impact the number of alerts that would be issued.

[Len Webber, Conservative, Calgary Confederation, AB]

I'll continue on here.

The network has now been restarted, I take it. Is the system fully functional now? Does it have a larger or smaller budget than it did back in 2016?

[Karen Hogan]

Again, those are all things that happened after our audit. My apologies. I don't know if I would even categorize it as stopped and restarted; I would categorize it as its expectations changed when it wasn't clear to us during our audit why an alert had not been issued.

These are all excellent questions that I would hope the agency can respond to.

[Len Webber, Conservative, Calgary Confederation, AB]

Ms. Hogan, do you plan on doing an audit on GPHIN in the near future?

[Karen Hogan]

I believe in making sure that we go where there isn't already evidence, so I am going to wait to see what this independent report on the Global Public Health Intelligence Network comes out with. We will monitor the actions taken by the agency in response to our recommendations. That's a commitment I have made: that we will do some more follow-up work. Then we will see whether or not it warrants our returning.

[Len Webber, Conservative, Calgary Confederation, AB]

Okay.

Madam Chair, I must be close to the end.

[The Chair, Conservative, Kelly Block]

I think you have about 45 seconds left.

[Len Webber, Conservative, Calgary Confederation, AB]

Are there any comments from any of the witnesses on any of these questions with regard to PHAC? Is there any information there?

I take it there's not, Madam Chair. I will pass on my time.

[The Chair, Conservative, Kelly Block]

Thank you very much, Mr. Webber.

We will now go on to Mr. Blois for six minutes.

[Kody Blois, Liberal, Kings—Hants, NS]

Thank you, Madam Chair.

Thank you to the witnesses for their testimony here today and their continued work.

Ms. Hogan, I'll start with you.

Around health surveillance information, for someone who would be sitting at home watching this, what exactly does that entail in your mind, in layman's terms, as quickly as you can, from the work you've done?

[Karen Hogan]

Health surveillance information is about sharing data around infectious cases, so it would be the age and the ethnicity of the individual, with a key factor being symptoms and when these were identified. It helps to enable tracing, I guess, and to understand the potential of spread.

It's key information that the Public Health Agency does need on a nationwide basis when we're in the middle of a pandemic or at the beginning of a pandemic in order to adjust its response across the country.

[Kody Blois, Liberal, Kings—Hants, NS]

Mr. Stewart, as the deputy minister for PHAC, how is that information generally disseminated? It's clear for me, or at least in what the Auditor General has said, that we have a bit of a legacy issue in this country, perhaps around our constitutionality, where there doesn't seem to be an easy transfer of information between the federal government and the provinces as it relates to health care. How generally is this health surveillance information shared?

[Iain Stewart]

A lot of the information is gathered and made public by the provinces and territories themselves in their reporting. We do have data-sharing agreements and relationships. For instance, right now, during the vaccine rollout, they are providing us weekly updates on the coverage of the different populations that they are vaccinating and so on, but as you just said, quite insightfully, it is an area of federal-provincial jurisdiction, so these arrangements are arrived at collaboratively.

[Kody Blois, Liberal, Kings—Hants, NS]

Ms. Hogan, you mentioned in your report the federal-provincial-territorial public health response plan. As illustrated in exhibit 8.2 of your report, part of the plan essentially was that there would be actual rehearsals or practices for how this plan would play out in real life. That didn't happen.

Can you speak to whether or not that's clear at this point? I guess it's clear that the practice didn't happen. Do we know whether or not the contents of the actual report were generally met in response to this pandemic? Yes, we know there wasn't an actual practice, but in theory, when the game happened, how well did we meet our plan? Or is that going to be part of a subsequent audit that you may take on?

[Karen Hogan]

You're accurate in your description that a testing of the plan hadn't happened. It was identified as being critical and that it needed to occur. The agency was in the planning stages of having a rather comprehensive test.

I guess I just want to highlight why a test is important. Some people might think it's kind of silly to have a plan and test it, but it allows you to identify whether or not roles and responsibilities are clear, whether there are gaps in resources or in expectations and where you might have obstacles that you're going to have to overcome in the event of an emergency.

As for what we saw at the beginning of the pandemic—recognizing that our audit only went to the end of June, so it hasn't extended beyond that time frame—we did see that it informed the response. One of the elements of the plan was to create a special committee that included the Chief Public Health Officer of Canada and her provincial counterparts. We saw that committee coming together, meeting and discussing.

The plan was almost live-tested, I guess. It would be up to the Public Health Agency, as it committed to do a lessons learned exercise, to inform whether or not it was effective and what the gaps and obstacles were and how to fix those going forward.

[Kody Blois, Liberal, Kings—Hants, NS]

Mr. Stewart, one part of the report that I found a little interesting, and perhaps troubling, is paragraphs 8.82 and 8.83, which talk about the pandemic risk assessment and how the reports that were being tabled, basically from June to March, were really looking at the status quo in Canada at the time and perhaps not looking at the global context of what was moving forward.

Mr. Stewart, can you speak a bit to about why that was the case, and perhaps whether or not that led to some of our measures at the border in how we were responding to this?

[Iain Stewart]

I think it was a learning process—the way you're describing. With our original assessments, which are well documented and which the Auditor General speaks about, it would be fair to characterize that it took the severity of the situation to manifest and then we responded to that.

One of the ways that we responded, as you were pointing out, was in beginning to establish a series of border measures in response to what was happening externally. That was a process of ramping up, which has continued to this day, per my opening remarks. We've added more and more border measures, as you know.

It was a response to what was happening externally. As the Auditor General points out, there was delay, I think, in recognizing the need to put those measures in place.

[Kody Blois, Liberal, Kings—Hants, NS]

I have about 35 seconds left.

As an Atlantic MP sitting in Nova Scotia, of course—we have four international airports in this country where PHAC has testing going on—there have been questions in my province about whether there would be a fifth airport established to support the Atlantic provinces. I don't know whether that has been discussed.

Can you talk about why it's those four international airports and perhaps the lack of coverage in Atlantic Canada?

[Iain Stewart]

That's an excellent question.

To be quick, the original focus was on volumes and the organizational resources required to stand up the kinds of measures we're doing, such as testing and so on. I think there's a live and ongoing discussion around what happens next. Certainly Stanfield airport is important and takes a lot of international flights, and would be one of the ones that would be in the next layer of the onion, as it were.

[Kody Blois, Liberal, Kings—Hants, NS]

Thank you very much.

[The Chair, Conservative, Kelly Block]

Thank you very much, Mr. Blois.

We will move on to Mr. Blanchette-Joncas for six minutes.