Public health pandemic 'alert' system didn't operate as intended for COVID-19: report

International partners that rely on Canada's information were left in the dark, report says

CBC.ca
March 22, 2021

An interim review of the failure by the federal government's pandemic early warning system to issue a formal alert on COVID-19 describes a lack of detailed knowledge of the system among senior managers.

The audit, dated Feb. 26 and released on Saturday, was ordered by federal Health Minister Patty Hajdu in response to reports that the Global Public Health Intelligence Network didn't operate as intended at the onset of the pandemic.

The interim report concluded that the news monitoring system did identify the outbreak of the pneumonia that would be known as COVID-19 on the night of Dec. 30, 2019, and included this information from Wuhan, China, in a special report to Canadian public health officials the next day.

But the report noted that without a formal alert, international partners relying on Canada's information were left to rely on other sources.

Inside Canada's frayed pandemic early warning system and its COVID-19 response
"That [the system] identified early open-source signals of what would become COVID-19 and promptly alerted senior management does not mean that the system is operating as smoothly or as clearly as it could and should," the report concluded.

"As international subscribers only receive alerts, some jurisdictions did not receive an early signal directly."

The review panel includes Mylaine Breton and Paul Gully, both experts in public health and health policy, and Margaret Bloodworth, who has a background in national security.

No standard operating procedures, report finds
The panel's report also found that prior to the pandemic, the alert system lacked standard operating procedures and senior managers didn't fully understand the "purpose or audience" for alerts.

The system is set up to gather thousands of online media reports from around the globe, which are narrowed down to items that are deemed credible enough for public health officials to explore further and compiled into a daily report.

But more serious items about potential pandemics and other risks are to result in "alerts" telling subscribers that "there is a signal they may wish to take notice of or follow up on," the report said.

The review found there were no written procedures for these alerts prior to fall 2020.

"The panel has also heard from some senior management directly overseeing [the system] who could not describe the purpose or audience for alerts, and may not have had a complete understanding of their intent," the report says.

Variation in frequency of alerts
The system was set up in the 1990s to scan the internet for open source news and early signals of health threats. Over time, it received upgrades to allow it to use human analysis to track the threats and -- according to the review -- provided the World Health Organization with about 20 per cent of its early-stage intelligence on epidemics.

There's been wide variation in the frequency of these alerts over the past 10 years, with 887 sent out in 2009 -- largely in relation to the H1N1 pandemic -- and 198 in 2013, corresponding with the H7N9 outbreak. Only one alert was issued in May 2019.

The panellists said it's clear that "some form of direction was given to pause the alert process," and that the level of approval for alerts was elevated and then downgraded at least once.

The authors also said that, so far, they haven't seen any written documentation on the timeline of those changes, who requested them and why they might have occurred.

The panel will continue its review in the coming months by looking deeper into how the system operates. They'll be examining the system's high degree of staff turnover and a decline in the number of internal experts with public health credentials.