Break the cycle of neglect and panic in public health

Posted on April 25, 2020 in Health Debates

Source: — Authors: – Opinion/Editorial

It’ll take months, years in fact, to learn the lessons of the crisis we’re all living through. There’ll be time aplenty to identify the mistakes that have been made, and figure out how to avoid them in future.

But it’s not too early to draw one important conclusion: the public health system we rely on to protect us against such pandemics is broken, from top to bottom.

Acknowledging that isn’t about scapegoating individuals. The people in charge are, overwhelmingly, dedicated and hard-working. No doubt they’re doing the best they can with what they’ve got.

But, collectively, both in Canada and around the world, we’ve downgraded and underfunded key aspects of public health, even though it’s done more than anything else over the years to lengthen our lives and improve our well-being.

When crises like SARS, Ebola or COVID-19 erupt, governments rush to pour in money, only to starve the system again once the urgency passes. This maddening cycle, says one commentator, amounts to “neglect, panic, repeat.”

Start at the top, with the World Health Organization (WHO). It’s become all too apparent that the WHO bungled its response to the coronavirus, that by its very nature it’s too politicized and cumbersome to do the job we thought it was there for — provide effective and truly independent scientific guidance on preventing pandemics.

At this point the WHO is badly discredited; even Canada, which defended the organization against critics like Donald Trump, now agrees there’s a “critical need” to review its shaky performance. It should either be fundamentally reformed, or a new organization that puts science ahead of politics must be created. Like-minded countries, Canada included, might cooperate to do that.

But both options are long-shots, given the entrenched national interests involved in a UN agency like the WHO. So, at the very least, countries like Canada should look to other, more reliable sources for advice and learning.

They should stop quoting the WHO as if it was the sole source of wisdom on pandemic-related matters. They should spend more time studying the success of countries that have shown they know how to fight pandemics successfully, such as South Korea and Taiwan.

Closer to home, Canada has made its full share of mistakes under a succession of governments, both Liberal and Conservative. There’s plenty of blame to go around.

As far back as 2006, in the wake of SARS, Ottawa set out a pandemic preparedness plan that should have made this country as ready as any for a threat like COVID-19.

But governments, and public sentiment, being what they are, that didn’t happen. Such plans call for spending many millions on something that isn’t happening — and we fervently hope will never happen. The temptation to cut corners, to trim “fat” from health budgets in favour of more pressing needs, is always there.

We had a couple of fresh reminders this week of what that has actually meant on the national level.

Ottawa, it turns out, has been cutting funding for management of its stocks of personal protective equipment like medical masks and gowns, known as the National Emergency Strategic Stockpile.

When it closed a warehouse for such gear in Regina last year, according to CBC News, it tossed out two million expired N95 masks and 440,000 medical gloves.

In a properly managed system, that gear would have been distributed to hospitals and clinics while fresh equipment was rotated in. But at a time when pandemics seemed like distant threats, no one cared much about stocks of PPE gathering dust in warehouses.

At the very least, let’s resolve never to let that happen again. The few million dollars saved by squeezing the NESS system now seems paltry beside the worldwide chase after scarce and expensive protective equipment.

Then there’s the state of the system that’s supposed to act as Canada’s early-warning tripwire on global health emergencies like pandemics. Called the Global Public Health Intelligence Network, it was created in 1997 as an online alert system.

According to an eye-opening report by CBC News this week, it was in the midst of a long-overdue technical upgrade when the coronavirus emerged. Its antiquated technology couldn’t take account of social media reports, and so may have missed some crucial information coming out of China.

Who knows if that made a meaningful difference? But it’s part of the dismal pattern of under-investment in public health.

In Ontario, too, there are signs that all has not been as it should be. As the Star reported in detail, the province fell behind badly on testing in the early weeks of the pandemic and is just now catching up.

It’s not clear quite why that is, but Premier Doug Ford has hardly bothered to hide his frustration with the shortcomings of the system. He promises to fix the “cracks in the ship” once the crisis passes.

That will be vital. Even more important will be to break the cycle of “neglect, panic, repeat” that left us with such inadequate protection against the plague that has upended our lives. Public health must never again be made the orphan of the health system.

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