First of all, I just want to expand on what Dr. Spika said. Even though it's called a pandemic plan, we also react to what's happening on the ground.
As was mentioned with Nova Scotia and B.C., we also had a lot of tourists coming back from Mexico. We had already activated, to some extent, the alert among ourselves. As soon as we heard there was an unusual illness going on in Mexico, we had weekly and then daily phone conferences to keep track of what was going on.
Through our provincial labs, Alberta in my case, we had reports of people being diagnosed with a novel strain of influenza. Way before it was declared a pandemic, we had already started to take action. Of course, we didn't have vaccine available in the first wave, but we knew something unusual was evolving and we needed to act. I think we did that as a nation. We developed our guidance documents together.
Your question is around the flexibility we need at the provincial level. First of all, I think we are hit differently. For example, Alberta was the first place that had first nations people who were affected. We had the first death. We had the first disease emerge in pig farmers, for example. In our case, we had a lot of firsts going on. We had to adapt the plan to fit the circumstances we were dealing with.
Those circumstances were localized, but they were also related to the way our health care system is structured. For example, in Alberta at the time, we had just abolished all the regional heath authorities and had created a single one. Therefore, the structure of response had to be different from that in Ontario, which has a very different type of health care system.
Even though we all endorsed a similar plan and signed on to the prioritization list, it played out a little differently in terms of implementation. For example, in Alberta, where they had chosen to use mass clinics for the immunization program, although in our communications to the public we highlighted who should come first based on the national plan that had been developed jointly, initially they didn't have the structure to screen people at the door. Basically whoever came to the clinic was accepted and was immunized.
That was a difference in what might have been done in another jurisdiction. Although we were still providing the same guidelines to our front line people, in our public communications we were using the same list as everybody else.