Good afternoon, ladies and gentlemen.
I am honoured to have received your invitation. Thank you.
Like you, I am a Canadian who wishes to get our country out from under COVID-19. I come at this as a professor of both public health and law at the University of Ottawa. I learned my science—latterly immunology—at Berkeley, Caltech and Oxford, and my law at UBC. After that I taught public health and government at both Harvard and Yale, and worked on global health projects with various NGOs, the World Health Organization, governments and corporations. As a science communicator, I've been part of the editorial team of the Canadian Medical Association Journal and The Lancet.
Today, however, I'm testifying as an individual. Unlike some of your other witnesses, nobody except the university pays my salary, so I have no conflict of interest to declare.
I am here today because I want to explain, scientifically, how to get Canada out of the dark tunnel we are in. There is light at the end of this tunnel, but whether we get there quickly or slowly, safely or dangerously, depends on the choices of government and the oversight of Parliament. Since much of what I'm saying was published in Maclean’s three weeks ago—you have a copy of my article—there's no need to take notes on this boring little lecture of mine.
Let's break it down into two parts. First, let's discuss what government can do right to save lives and rescue our families and businesses; and later, let's talk about what governments did horribly wrong leading to this pandemic.
As we are talking, right now, most provinces are at or nearing the crest of the first wave of infections. Thankfully, it is not a tidal wave, because self-isolation, quarantine and “social distancing” all worked and broke the chain of infection temporarily.
However, I must emphasize that surviving that first wave is not a victory. Social distancing bought us time, but it does not solve the problem. There's an endgame that lies ahead, which will take over a year. Why is this? It's because most of us still haven't met SARS-CoV-2, which is the virus behind COVID-19, so we haven't fought off the virus and developed immunity to the virus.
If you think back to a month ago, Canadians went into self-isolation because most didn't have immunity, and isolation was the only way to avoid getting crushed in a catastrophe. Since then, isolated Canadians have been through a lot of beer and TV, but sitting on our bums, as we have, has not magically made us immune. Netflix does not a vaccine make, and we are just as immunologically susceptible as before, meaning that if isolation ends for everyone at the same time, we will immediately return to the same hellish spot that we just dodged.
The endgame must not relax self-isolation for everyone at once; instead, it has to be in careful, scientifically tailored stages. There is no other way—none—to reopen Canada. What I'm saying is that instead of “flattening the curve”, which is a misleading, scientifically wrong metaphor that really shouldn't be used, really the endgame is about stretching and slicing the single giant curve of infections into a timed series of a number of scientifically planned, measured curvelets. To use an analogy, imagine a giant wildfire that rips through a whole forest. Now instead of that, imagine asking the fire chief to light smaller, controlled burns over time. The forest still burns, but the harm is less. Stretching and slicing the epidemiological curve into managed curvelets is like that controlled burn.
In the hands of a well-informed public health chief, staging these disease curvelets does not stop people from getting sick with COVID. It does, though, make it manageable, and it reduces the number of people dying of COVID. Short of a vaccine, which is absolutely out of reach in 2020, staged curvelets are not just the best we can do. They are the only thing we can do.
This brings me now to my dissatisfaction, and a plea for Parliament’s help.
As we sit here, we have federal and provincial governments that are botching this endgame. To date, neither the Minister of Health nor Dr. Tam has presented a concrete plan for staging the curvelets, and we need one now. Worse, they are concealing data and interfering with outside scientists solving the problem.
I emphasize this to you: It is impossible for scientists inside or outside government to do the best job of planning these curvelets without excellent disease surveillance, data sharing and epidemiological modelling. The next steps to reopening Canadian society, which we all want, by curvelets, must be planned exquisitely or we will accidentally kill people. Then once each curvelet is launched, local public health officers everywhere need more and faster COVID testing than they have, so as to detect and stamp out little outbreaks before they explode.
However, in all these areas—the testing, epidemiological data and modelling—Canada’s performance is pretty dreadful, compared with leaders such as Hong Kong, Norway, South Korea or Switzerland.
Let me explain. Scientists need transparent data on the disease from every province to make mathematically and medically accurate disease models and forecasts. We're not there, because the provinces hold the data, and sharing it with the Public Health Agency of Canada is optional. They have no legal obligation to share. Then, even more foolishly, the Public Health Agency of Canada censors the data before it's disclosed to scientists, probably to avoid embarrassing certain provinces.
The result is that scientists inside and outside government only have an incomplete data picture to work with, and with one eye gouged out, they can’t churn out the best possible epidemiological forecasts, meaning that we as Canada bumble into this end game unfit and unready. Just like farmers need accurate weather forecasts for planting, we need accurate epidemiological forecasts in this business too, or people will needlessly die and the economy will needlessly suffer.
Probably because of these data sharing failures, PHAC is struggling to model the epidemic. Last week Dr. Tam presented a tiny bit of the PHAC model, but frankly it was incomplete, it contained errors and it was largely unscientific. This drove some of us from universities in Berkeley, London, San Francisco and Ottawa to release our own model this morning. I wish it had been shared with you. Apparently it cannot be; otherwise, I'd be able to present you some of the results, some of the key findings. It is the first epidemiological model of all of Canada over the coming year.
At the end of the day, it is a real problem that these data-sharing gaps exist. Parliament heard from the Auditor General in 1999, 2002 and 2008 about the government’s failure to prepare for disease emergencies. The Auditor General put her finger on data sharing as a problem three times. Then in 2003 Canada was hit by SARS severely, and the federal government did a “lessons learned” study, which recommended that Parliament legislate data sharing between the federal and provincial levels. It wasn’t done. Five years later, the unanimous editors of the Canadian Medical Association Journal again howled at Parliament to legislate open data sharing. We were ignored.
Now, members, I implore you. Legislate rules for data sharing immediately, or we can't build the best models and give you the best forecasts and you will lose lives. While you are at it, set minimum national standards for how Ottawa and the provinces plan, prepare and act during pandemics. Constitutionally, health is a shared jurisdiction, whether it's emergency legislation, or using the federal government’s quarantine power in subsection 91(11) of the Constitution Act.
Take this on as a private member's bill. Override the Standing Orders if you have to. Just don't wait for the government to do it. The Prime Minister won't do it. Look at the mandate letters he gave his health ministers, Dr. Philpott, Ms. Petitpas Taylor and now Ms. Hajdu. None of his three mandate letters even mentions pandemics.
I'm not pleased with Mr. Trudeau for, despite warning upon warning, pandemic preparation was never even the lowest of his priorities for his ministers. If you wonder why even simple things, like stockpiling N95 masks for our nurses and doctors didn't happen, it's because pandemic preparation was never a Canadian priority, and so now it falls on the House to do better.
I stand ready to help the House in any way that you ask in the climb toward the light at the end of the tunnel, but let me be clear. Canada is in a predicament because Canada prepared poorly. The virus is the biological agent of the pandemic, but government failure is the cause of our plight. To me, this is not a scientist's pandemic, but a bureaucrat's pandemic brought on by ignored warnings and quite miserable laws.
Now the end game is upon us. The efforts of this Parliament will leave historians to decide whether Canada did all it could to fight the pandemic and to prepare for the next pandemic—and, yes, there will be a next pandemic. Scientists can give you quite decent guesses about it. Let's just say that COVID-19 isn't especially bad and we've anticipated much worse.
Thank you for bearing with me. I apologize for these extraordinarily blunt messages.
I'm very pleased to take your questions or maybe your fire.
Thank you very much.