Reuters

Paul-Émile Cloutier

January 5, 2022

When the COVID-19 epidemic was declared a pandemic by the World Health Organization on March 11^th, 2020, Canadians – along with human beings across the world – processed the news within a frame of reference based on history. Our expectations were informed by our most recent experiences with the concept of contagion. Those included the 2003 SARS epidemic, which infected 8,000 people and killed 774 worldwide, 44 of them Canadian; and the Ebola outbreak centred in West Africa that peaked in 2014 before killing a total of 11,000 people. No Canadians were among them.

Based on our confidence in 21^st-century reporting, diagnostic, treatment, containment and public education systems vastly more sophisticated than those available during the last deadly global pandemic – the influenza outbreak of 1918-20 that killed 50 million people, including 50,000 Canadians – none of us could have anticipated the narrative trajectory of COVID-19.

“We have never before seen a pandemic sparked by a coronavirus,” WHO Director General Dr. Tedros Adhanom Ghebreyesus said when he first declared the pandemic that day in Geneva. “This is the first pandemic caused by a coronavirus.”

Nearly two years later, vaccines have mitigated the impact of this unprecedented coronavirus pandemic in terms of containment and mortality, but vaccine denial and mismanagement have kept the contagion alive. Those factors have enabled variants including Delta and Omicron to rationalize ongoing socioeconomic impacts with successive waves of isolation, quarantine and lockdown.

On December 14th, the WHO warned that the Omicron variant was spreading “at a rate we have not seen with any previous variant.” The organization urged countries around the world to use all anti-COVID tools to prevent health systems from being quickly overwhelmed as the holiday season approached. WHO also painted this startling picture of the state of global immunization: 41 countries had still not reached 10 percent vaccination of their population, and 98 countries had not reached the 40 percent vaccination mark.

As our third calendar year in this epidemiological disaster dawns, it has become cliché in my field of health care policy to roll out the Einsteinian truism that every crisis contains opportunity. Let’s deploy instead another “O” word: obligation.

In tabling her annual report on December 13th, Dr. Theresa Tam, Chief Public Health Officer of the Public Health Agency of Canada, said: “There is a lack of a coherent public health system in Canada…Indeed, our publicly funded health care system is composed of a series of disjointed parts, separated by jurisdiction divides and plagued by ‘boom and bust’ cycles of public health spending where resources are scaled back.”

The next day, the federal government’s fiscal update was tabled. It included additional measures to help Canada respond to the Omicron variant, but the short-term focus of the spending meant that many of the health system vulnerabilities exposed by the pandemic have yet to be addressed. Canada’s health care system and those who work in it are in desperate need, as I pointed out in my response to the fiscal update as president of the group representing health care organizations and hospitals across Canada, adding: “Our political leaders must urgently come together to implement solutions to the challenges facing health care and health research.”

Which is where obligation comes in. There’s always a temptation, in formulating public policy, to wait until a situation has moved beyond crisis management to make systemic changes; or, in health care terms, until the patient stabilizes before a comprehensive examination of the symptoms and well-informed diagnosis can be reached.

Canada’s health care system is now the patient in this scenario, and our political leaders have not just an interest but an obligation to devise an effective intervention to stabilize the system so that it doesn’t become the biggest, costliest casualty of this pandemic.

HealthCareCAN exhorts on behalf of Canadians our federal and provincial political leaders to urgently address the following, ideally and most practically with a First Ministers Conference in the first quarter of 2022.

A pan-Canadian health workforce planning strategy: The federal government must collaborate with the provinces and territories to identify, prioritize and establish a national strategy to address systemic health workforce shortages. This includes data gathering, benchmarking, research, interprovincial coordination of education and licensing, and so on to ensure Canada’s health workforce aligns with the needs of Canadians, addresses factors that contribute to stress, anxiety and burnout among health care workers, and improves diversity, representation and equity in the health system.

Strengthening health research and innovation: Canada’s health researchers and health research organizations have been invaluable in the fight against COVID-19. The important innovations and discoveries that have helped us get through the pandemic were built on decades of research. We must continue to bolster the health research and innovation sector to tap into its innovative and economic power – for the good of Canadians’ health and Canada’s economy.

Improving access and availability of mental health supports: The rising rate of burnout among Canadians and health care workers demands federal, provincial and territorial leadership and coordination. In addition to implementing a national health workforce planning strategy to better support our health care workers, governments must also develop a comprehensive approach to improve the availability and access to mental health services for all Canadians. The appointment of a federal Minister for Mental Health and Addictions is a good first step, but there is much to do to improve equity in mental health services throughout the country.

Sufficient health transfers: We have learned that the Canada Health Transfer (CHT) will be $45.2 billion in 2022-23, far less than the approximately $70 billion sought by the provinces. How will the Government of Canada be able to bring governments and territories together at a national table to discuss fundamental reform of the Canadian public health system and its provincial/territorial components?

National standards for pandemic health policy: Increased health transfers to provinces and territories are urgently needed to ensure consistent, long-term funding for public health and to eliminate inequities and gaps in our health care system. This investment must keep pace with costs, and ensure standardized, timely, and reliable data collection by developing a set of guiding principles across provincial/territorial jurisdictions, to help Canada respond to outbreaks now and in the future.

For months, HealthCareCAN has been stressing the importance of establishing a true national dialogue that would lead to fundamental reform of the health care system. After five successive waves of the pandemic, we can no longer accept the improvisation that continues to destabilize the health care system across the country. Canadians deserve better, and we have an obligation to deliver it.

Paul-Émile Cloutier is President and CEO of HealthCareCAN, the national voice of healthcare organizations and hospitals across Canada.