In August, the respected and influential British Medical Journal (BMJ) published a series of articles investigating the Covid-19 response in Canada. Contrary to the impression of many Canadians that Canada handled the Covid pandemic well, especially as compared to the United States and the UK, the BMJ had a long list of skathing criticisms, and stated in several places that a national enquiry is needed to make sure that important lessons are learned for the future.
“The picture that emerges is an ill prepared country with outdated data systems, poor coordination and cohesion and blindness about its citizens’ diverse needs. What saved Canada was a largely willing and conforming populace that withstood stringent public health measures and achieved among the world’s highest levels of vaccination coverage. In other words, Canadians delivered on the pandemic response while its governments faltered.”
… The Guardian
“The willingness of Canadians to comply with vaccination requirements and harsh public health restrictions did more to bring Covid-19 under control than the fragmented, deficient and unsavvy response of governments … Canada leads wealthy nations for Covid related fatalities in care homes, despite more than 100 reports and inquiries over 50 years that foreshadowed a nursing home crisis … More long-term care home outbreaks occurred in 2022 than 2020 and 2021 combined.”
… National Post
During the pandemic, many articles in this blog were pretty critical of the decisions and actions taken, and the actions not taken, from public health officials to politicians. The vaccine rollout was particularly chaotic. People scrambled to find out where they could get a vaccination and in the beginning a lot depended on word of mouth. It took Ontario three months to provide a vaccine reservation system, but for weeks it was overloaded and crashed, making it difficult for people to book a shot. In the meantime Doug Ford blamed Justin Trudeau for not delivering enough vaccines. The botched vaccine rollout was a classic case of a series of bad management decisions. The effect was that vaccine distribution was inequitable for many and stressful for everybody.
Bad Management 1. No planning for a vaccine rollout
By May 2020 it was clear that the results of the phase 3 clinical trials for the Moderna and Pfizer vaccines would be submitted to the FDA by December 2020 and that with fast track approval, vaccines would be ready to ship in January 2021.
Neither the federal nor provincial governments began any serious planning until vaccine deliveries were confirmed in December.
Here is a revealing interview that makes this clear. One week before the first batch of vaccines were due to be delivered, the CEO of UHN, which was the first vaccine distribution center for Toronto, had only a few vague answers but no answers for a lot of key questions that should have been planned many months before.
“How will we make this logistically work?”
“Healthcare workers have been really busy, do we have the right people?”
“We have not been told anything about the next batches of vaccines.”
Bad Management 2. Poor selection of leaders
The Trump administration appointed F. Perna, a four-star general and a logistics expert, as the chief operating officer of “Operation Warp Speed”. The thinking was that the major challenge of the vaccine rollout was the logistics to move vaccines from suppliers to vaccine centers and that military people had the experience with these kinds of logistics. Canada followed suit as did Ontario.
At the end of November, about one week before vaccines were due to arrive in Canada, Trudeau appointed Major-General Dany Fortin, a former NATO commander in Iraq, to head up the Federal vaccinations task force. A short time later, Doug Ford appointed former head of the Canadian Armed Forces, General Rick Hillier, to lead a new task force to oversee the rollout of the Covid-19 vaccines in Ontario.
What shallow thinking. Using large military aircraft to move military equipment and thousands of troops across the globe is a logistics problem that is quite different from shipping boxes of vaccines from a handful of suppliers to a few vaccination centers across the country. The “logistics” of shipping vaccines from suppliers to vaccination centers is the easiest part of the overall vaccination distribution. The challenging part is how to get the vaccines from vaccination centers into the arms of millions of people. Who was going to administer the shots? Nurses were overloaded with Covid cases in the hospitals. Would additional people be recruited? Who would train them? How would people get their vaccinations? Would they line up for hours in ad hoc locations such as community centers or would modern technology be used so that people could reserve in advance at a time and location of their choosing? What about the many people who couldn’t use the Internet? Would there be enough phone lines and people to answer the phones to provide information and help people book a reservation?
The high rank military generals had many years of experience in the military but no significant experience working in civilian life. The values and orientations of the military focussing on preparing for battle or securing defensive positions is quite different. This was clearly born out when General Hillier suspended the vaccination program in Ontario in December 2020 so that people could enjoy their holiday season. He clearly did not understand the urgency that civilians wanted to proceed with vaccinations as quickly as possible. A pause in vaccinations was as absurd as firefighters leaving a five alarm blaze for a lunch break. The public outroar was furious and Hillier had to walk it back quickly, issuing an apology and promising not to take off any more days in the vaccine rollout. Hillier resigned three months later. He was replaced by someone with a medical background, Homer Chin-nan Tien, the president of the air ambulance service Ornge.
In spite of the grandiose statements about the expertise of the Canadian military, there seems to be only one case of military planes being used, to deliver 5 freezers for Canada’s North.
On the other hand there were many interviews and photo ops with the Minister of Procurement Anita Anand on the tarmac meeting large cargo planes arriving with vaccines. They were always FedEx planes.
Lessons Learned?
“Lessons from the outbreak of SARS-CoV-1 in 2003 which impacted Canada more than any other country outside of Asia went unheeded and left the country’s governments and health authorities ill prepared for Covid-19. An independent, national inquiry is needed to review Canada’s Covid-19 response, draw lessons, and ensure accountability for the past and future pandemic preparedness.”
… British Medical Journal
There is no commitment or announcement from the Canadian government to undertake such an inquiry.
Is Canada going to learn from the lessons of history, or is Canada doomed to repeat history, again?
