Journal series calls for inquiry into Canada’s COVID-19 response

A new series published in the medical journal BMJ calls for an independent inquiry into Canada’s COVID-19 response.

Experts from 13 organizations across Canada, including doctors, nurses, researchers, legal and humanitarian professionals, and the BMJ’s international editor-in-chief, Canadian Jocalin Clark, authored the seven articles that appeared late Monday.

“We see this as the next step in the pandemic,” said Dr. Sharon Strauss, attending physician at St. Michael’s Hospital in Toronto and one of the senior authors of the series Accountability for Canada’s COVID-19 Response.

“This is the beginning of preparations for the next emergency,” she said.

The article highlights shortcomings in Canada’s COVID-19 response, including difficulties in reaching the most at-risk and vulnerable marginalized populations, devastating deaths in long-term care facilities, and inconsistent public health messages across provinces and territories.

The article also acknowledges Canada’s pandemic response successes, including vaccination rates of over 80 percent.

In a BMJ editorial summarizing the findings, the authors said, “A two-year post-pandemic assessment showed the country had lower COVID-19 cases and deaths and higher vaccination coverage than other G10 countries.”

“However, this overall impression of relevance masks important inequalities by region, context and demographics.”

Strauss said a series of articles previously published in the BMJ on the UK’s COVID-19 response provided useful information for investigations there, and the authors hoped the same would happen in Canada.

Essential workers and marginalized communities

Strauss said it’s important to look closely at who carries the “burden of the pandemic.”

Among them are essential workers who live in low-wage, disadvantaged areas, she said.

One of the lessons Strauss hopes to learn from research on the COVID-19 response is how important it is to “build relationships with communities most likely to be caught up in these health inequalities before the next health emergency occurs.”

These relationships will help ensure that marginalized communities are included in research and that their needs are prioritized in public health assistance, she said.

Failure of long-term care

Research is needed to ensure “accountability for losses,” including the 53,000 deaths in Canada, many of them in long-term care, the authors said.

“Especially shameful, Canada leads the wealthy nation in terms of COVID-19 deaths in nursing homes, despite more than 100 reports predicting a crisis in nursing homes,” they wrote.

Strauss said the reports highlighted problems such as chronic underfunding and lack of adequate support for staff in long-term care.

He said some state governments are already reversing some of the measures they introduced to strengthen long-term care, such as sickness benefits for staff. Strauss also said it’s important to keep long-term care homes out of four-bedrooms, where COVID-19 and other illnesses can easily spread.

“We have a responsibility to make sure that those who have died do better because of them … so that it never happens again.

Regional disparities and labor shortages

The authors write that the national survey should also include recommendations on “reform of Canada’s healthcare and public health systems, which have struggled pre-pandemic and are now on life support.”

Canada has “continued a severe labor shortage” due to the “exodus of exhausted and distressed health care workers” due to the effects of the new coronavirus infection, he said.

Canada’s decentralized healthcare system, in which provinces and territories are responsible for their own public health response, has contributed to inconsistent COVID-19 messages and directives across the country, according to the BMJ article.

Public Health Canada develops “national clinical and public health guidelines” but “lacks the authority to direct provincial and territory health agencies and other bodies with similar powers to implement the recommendations,” they said.

“Each state and territory has developed its own interventions and schedules for protective measures such as school closures, border controls and closures, bans on gatherings, and mandatory mask-wearing.

A key lesson to be learned from that is the need to be “explicit and transparent” about why different approaches exist in different regions, Strauss said.

She said the lack of transparency about why public health decisions are being made leads to “distrust”.

The authors write that it is “essential” to examine what has worked and what has not worked in Canada’s COVID-19 response through independent research.

“If you don’t look at the past, an unchanging future awaits you.

Undoubtedly, there are lessons to be learned for new healthcare investments and preparedness, and many lessons learned from failed or hesitant decisions and actions,” they wrote.

When asked to respond to the call for a national investigation and the issues raised in the BMJ series, the spokesman for the Federal Minister of Health Jean-Yves Duclos Guillaume Bertrand said in an email: “We are committed to reviewing the response to COVID-19 in order to take stock of the lessons learned and better inform our preparedness and response to future health emergencies.”

This report by the Canadian Press Agency was first published on July 24, 2023.

The Canadian Press’ health coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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