The Time to Act is Now: CDN Report Pandemic Science

Welcome to Heliox, where we dive deep into the heartbeat of Canadian healthcare. Today, we're unpacking a fascinating report that could reshape how Canada handles future health crises. In August 2023, Health Canada took a hard look in the mirror, commissioning a comprehensive review of how we managed the science behind COVID-19. What worked? What didn't? And most importantly - how can we do better next time?

From building a national health risk system to amplifying Indigenous voices in public health leadership, this report isn't just about learning from our past - it's about forging a stronger, more resilient future for Canadian healthcare. Join us as we break down the twelve recommendations that could transform how Canada approaches the next public health challenge.

Stay with us - this is a conversation you won't want to miss.

Report of the Expert Panel for the Review of the Federal Approach to Pandemic Science Advice and Research Coordination: The Time to Act is Now
https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/review-federal-approach-pandemic-science-advice-research-coordination/time-to-act.html#s9

Transcript

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Hey there, ready for a deep dive into something really important. We're talking all about pandemic preparedness in Canada. You know how to make sure we are way more ready if and when another global health crisis hits. Yeah, it's a critical conversation, especially given how COVID-19 really shone a light on both the strengths and the weaknesses of health systems worldwide. We've got a lot to learn. Absolutely. And you shared a report with us called "The Time to Act is Now." It has insights from a panel of experts who reviewed Canada's COVID-19 response. And this isn't just any panel, we're talking about some heavy hitters here. Oh, absolutely. Like Sir Mark Walport, who led UK research and innovation. Right. And Dr. Alison McGeer, one of Canada's top infectious disease specialists. These are serious people. So what are some of the big takeaways for us? Well, the report is incredibly thorough, but one thing that really jumps out is this need for speed. OK, that makes sense. When a health crisis hits, you got to move fast, right? Yeah, exactly. The panel found that while Canada created new systems and groups during COVID-19, getting them up and running often took too long. Think of it like a fire every second counts. It was like trying to assemble Ikea furniture while your in-laws are already at the door. Just stressful. The report also says that Canada needs a better system for spotting health risks, like way before they become emergencies. They even suggest something called a National Health Risk Register, which sounds kind of intense. It is, but in a good way. Think of it like the UK's approach. They have this public risk register that covers everything from floods to, you guessed it, pandemics. They update it regularly and it's out there for everyone to see. Wow. So they're literally saying, here's what could go wrong and here's how we're planning for it. That's incredible transparency. The report suggests that Canada should create something similar, especially when it comes to new diseases. We do have that national risk profile, right? We do. It's led by Public Safety Canada, but the report points out that it really focuses on the economic costs. So while it might tell you how much a pandemic could cost, it doesn't fully consider the direct impact on people's health. So it's missing that really human piece of the puzzle, the human cost. The report suggests creating a separate health risk register. This one would be led by health experts and would take what they call a One Health approach. What does that even mean? It's fascinating, actually. One Health recognizes that human, animal, and environmental health are all interconnected. Think about those recent bird flu outbreaks in dairy cattle, or how wildfires can impact air quality and make it really hard to breathe. These things affect us all. Makes total sense. You can't just look at human health in a vacuum, but how do we actually anticipate these risks before they become a problem? That is where horizon scanning comes in. Okay. Horizon scanning, that sounds like something out of Star Trek. It's a little more down to earth than it sounds. Think of it like your bank monitors your accounts for unusual activity to try and prevent fraud. Horizon scanning is essentially doing that, but for emerging health threats. So it's like a crack team of health detectives that are always on the lookout for the next big threat. I love it. And the report's very clear about this too. It can't just be a federal thing. Provinces, territories, indigenous communities, researchers, everybody needs a seat at the table. But that brings up another question. How do you coordinate a response across so many groups during a crisis? Especially since the report found that Canada really struggled with this during COVID-19. Yeah, you're right to point that out. While there was a lot of good intention, the sheer number of new groups and committees created on the fly made it hard to share information effectively. Too many cooks in the kitchen. In a way, yes. The report suggests streamlining things like creating a dedicated scientific advisory group for emergencies. Okay. Think of it like a rapid response team, but for science advice, that's ready to go the moment a crisis hits. So instead of scrambling to find the right experts when something happens, they're already assembled and ready to go. Exactly. And this group would have a clear mandate, strong support staff, and established processes for gathering and communicating the best and most up-to-date evidence. And I imagine a really diverse range of experts too, including representatives from indigenous communities. This report really seems to emphasize that point. It does. During COVID-19, the impact on indigenous communities was significant, but their voices and knowledge weren't always incorporated. One striking recommendation from the report is to create a new deputy chief public health officer focused solely on indigenous health. Wow. This would be a strong signal of a real commitment to addressing those systemic inequities. It's about making sure that those with firsthand experience are involved from day one, which is essential, not just for ethical reasons, but for effective responses. Okay. So we've got identifying risks, coordinating response, ensuring inclusivity, but what about the actual research that happens during a pandemic? Well, this is where it gets really interesting. While Canada did put a lot of funding towards COVID-19 research, the report found that it wasn't always as strategic as it could have been. So we had a lot of research projects, but they weren't necessarily focused on answering the most urgent questions. Exactly. Imagine you've got this toolbox full of tools, but you're not sure which one you need to use first. The report uses the UK's recovery trial as a good example of a more targeted approach. They were able to very quickly and efficiently test different COVID-19 treatments. What made them so much faster? Was it just luck? Not at all. They already had a dedicated funding stream set up specifically for pandemic research, and they had these streamlined processes for things that often slow research down, like ethical approvals and data sharing. Those were already in place. So they were in a much better position to hit the ground running when the pandemic hit. Yeah. What does the report say Canada should do to improve in this area? It really comes down to better coordination. The report recommends a central hub that involves everybody, government departments, research funders, to set priorities for research during health emergencies. So no more working in silos. Exactly. We need everybody on the same page asking the right questions and coordinating their efforts to find answers quickly. But here's the thing, even with groundbreaking research, it doesn't really mean much if it doesn't make it out of the lab and into the real world. We've all felt that frustration of seeing important findings stuck in academic journals. Absolutely. It's like having the cure, but not being able to get it to the people who need it. That's where knowledge translation is so important. Okay. So break it down for me. What does that even mean? It means making sure that research findings are accessible and understandable to the people who can use them, policymakers, healthcare providers, even the general public. We need to ditch the jargon and make sure we're using clear and concise language when we explain research findings to the public. So less academic jargon and more plain language that everyone can understand. Exactly. It's not enough to just publish research findings in journals and hope that the right people find them. We need to be more proactive. We need to actively share that information, engage with decision makers, and make sure the evidence is easy to find and understand. It's like having a dedicated team of science communicators that act as this bridge between the research world and everybody else. And speaking of making information accessible, one thing this report really stresses is the need for clear, accurate, and transparent communication during a health crisis. Absolutely. The report found that inconsistent messaging and a lack of transparency during COVID-19 were part of what damaged public trust. People need to feel confident that they're getting the whole story, even if it's not always what they want to hear. So it's about being upfront about things, even when the answers aren't clear. Yeah. And it's not just about being transparent. It's also about acknowledging uncertainty. We have to be honest about what we know, what we don't know, and how that lack of knowledge might affect decisions. And if we make mistakes, we need to own up to them. It all comes back to building trust, and that requires honesty and accountability. But even with clear communication, we still need reliable data to base our decisions on. Which brings us to another big issue. The report tackles Canada's data disconnect. What did they mean by that? Well, during the pandemic, it became really, really obvious that Canada's approach to health data was, to put it frankly, fragmented. Some provinces were doing a great job of collecting and sharing data, but others weren't. So it was like an information highway pileup. Why was that such a big problem? Well, imagine trying to coordinate a national response when you have different provinces, all reporting data in totally different formats on different timelines with totally different levels of detail. It sounds like it'd be chaos. Like trying to put together a puzzle, but none of the pieces actually fit. Yeah, that's a great way to put it. That's essentially what we were dealing with. The report points to a few things that caused this disconnect. We didn't have national data standards. We had different data systems that couldn't talk to each other. And there were inconsistencies in how researchers and public health officials could access the data. So it's not even enough to just have the data. You have to make sure that it's standardized, shareable, and usable. What does the report suggest we do about it? Well, it says that we need to make a major investment in building a more robust national data infrastructure. What would that look like, practically speaking? Well, it starts with establishing clear data standards. So everybody needs to be collecting and reporting data in the same way. And we also need to invest in what are called interoperable data systems. So these are systems that can seamlessly share information with each other. So it's kind of like a universal translator for data. Yeah, exactly. And of course, we have to make sure that researchers and public health officials can access the data they need quickly and easily without having to jump through hoops. It sounds like this would take a lot of coordination and collaboration between different levels of government. Absolutely. It's a big task. But the report argues that it's essential if we want to be more prepared for future health crises. And it's not just about how MUCH data we collect. It's about the TYPES of data we're prioritizing. And one of the most important points the report makes is that we didn't collect enough sociodemographic data during the pandemic, particularly when it comes to things like race and ethnicity. So we were missing critical information about how the pandemic was affecting different groups differently. Why is this type of data so important? Because if we don't have that sociodemographic data, we're basically flying blind when it comes to understanding health inequities. We need this information to see which groups are being disproportionately affected by a health crisis, figure out what factors might be contributing to those disparities, and then tailor our responses to meet the needs of different populations. It's about making sure that everyone has an equal chance at being healthy, regardless of their background or other social determinants of health. Precisely. And that brings us to another incredibly important aspect of data in public health, indigenous data sovereignty. That's something that comes up a lot in this report. Can you explain what data sovereignty means, especially for indigenous communities? It's the idea that data isn't just this neutral collection of facts and figures. Data actually represents people's lives, their experiences, their cultures, and their identities. For indigenous communities who have this long and really troubled history of having their data misused and exploited, data sovereignty is about taking back control. Can you give an example of how indigenous data was misused in the past? Oh, there are way too many examples, unfortunately. But the one that always comes to mind is when they were taking blood samples from indigenous children in residential schools without getting consent. They took those samples without the children's consent and without their parents' consent, and they did it under the guise of research, but it was a violation of their basic human rights. That's awful. It is. And it's a really stark reminder of why data sovereignty is so important. It's about making sure that indigenous communities have the power to decide what data is collected about them, how it's used, who has access to it, and how it's protected. So it's about self-determination. It's about ensuring that data is used to benefit indigenous communities and not to harm them. How do we make sure that indigenous data sovereignty is respected as we try to build this more robust health data system for Canada? The report really emphasizes that we need a major shift in thinking here. It's not enough to just consult with indigenous communities. We actually need to support indigenous-led data initiatives. What would an indigenous-led data initiative look like? Can you give me an example? Sure. One really inspiring example is the First Nations Information Governance Centre. They've developed their own data governance framework that's rooted in indigenous values and principles. They recognize that a one-size-fits-all approach to data governance simply doesn't work. Indigenous communities need to be in charge of their own data. So it's about partnership, not paternalism. What practical steps does the report recommend we take to actually strengthen data sovereignty for indigenous communities? It recommends increasing funding for indigenous-led data projects and also creating a dedicated indigenous data governance body that would advise the federal government on data policy. It really emphasizes that indigenous voices need to be heard at every level of decision-making. And it also says that we need to make sure those indigenous data principles are embedded in every aspect of how we collect and use health data. So it's about recognizing that indigenous data sovereignty is not just an indigenous issue. It's a Canadian issue. Yeah. And that we all have a responsibility to make sure that data is used ethically and responsibly. Exactly. It's about moving away from that colonial approach to data and towards something that's rooted in respect, reciprocity, and a real commitment to reconciliation. Okay. So we've talked about the need for more strategic research, clearer and more transparent communication, and addressing that data disconnect with a special focus on indigenous data sovereignty. That's a lot to process. And it's clear that there's so much work to do to strengthen Canada's pandemic preparedness. There is. But the good news is that we have a roadmap for improvement. This report gives us concrete recommendations that if they're actually implemented could really improve our ability to respond to future health crises and do it more equitably too. Feels like we're at this really crucial point. We've been through a lot as a country in the past few years, and now we have to make a choice. Do we try to go back to normal, whatever that even means, or do we take what we've learned from our mistakes and try to build back better? I like how you think. We can't let this opportunity pass us by. The report talks about how important it is to not just react to crises, but to anticipate them. We need to have foresight to look ahead, figure out what the potential threats are, and then put things in place that will help us deal with those threats before they become arrogancies. That idea of being proactive seems to be a recurring theme in this report. So as we head into the last part of our deep dive, I'm really interested to hear your thoughts on this. What are some of the key areas that you think Canada should be focusing on as we move forward? That's a really great question, and it's one that deserves a lot of thought. Let's dive into that in our next segment. So we've covered a lot in this deep dive, from the need for more strategic research and clearer communication, to the importance of addressing data gaps, especially when it comes to Indigenous data sovereignty. But I have to say, this idea of foresight, really trying to anticipate future health challenges before they become major crises, that's what's really stuck with me. But where do we even begin? It seems like such a daunting task. You're right. It's a huge undertaking, but that's why this report is so important. It's not just about fixing past mistakes. It's about creating a future where we're more resilient to these kinds of threats. So less about fighting the last war and more about preparing for the next one. Exactly. And the report highlights a few really important areas where Canada needs to focus its foresight. One that jumps out is that interconnectedness of human, animal, and environmental health. That One Health approach we were talking about. Because a pandemic like COVID-19, that doesn't just come out of nowhere. Right? Not at all. The report is really clear about this. We need to get a lot better at monitoring what are called zoonotic diseases. These are diseases that can spread between animals and humans. And you have to think about it, things like deforestation, climate change, even how we're raising livestock. All of these things can influence how new diseases emerge and spread. So we're talking about recognizing that human health is fundamentally connected to the health of the planet and every living thing on it. Exactly. The report argues that Canada needs to invest in things like research, surveillance, early warning systems, but through that One Health lens. So we're talking about monitoring things like wildlife migration patterns, different agricultural practices, even how climate change is affecting things like mosquitoes, which can spread disease. Wow. So we're talking about looking at the really big picture here. We are, but it's also about figuring out how those big picture issues connect to our everyday lives. For example, the report talks about antimicrobial resistance as a growing threat. Oh, right. That's when bacteria become resistant to antibiotics, which makes infections much harder to treat. Yes, exactly. And this is a perfect example of how human, animal and environmental health are all connected. When we overuse antibiotics, and this happens in both human and animal medicine, it actually fuels antimicrobial resistance. And we're already seeing the impact of this around the world. So this isn't just some abstract scientific problem. This could have a real impact on our ability to treat even common infections in the future. Exactly. So what can we do about it? Well, the report recommends a multi-pronged approach, so to speak. It talks about things like stricter regulations on antibiotic use, increased investment in research for new antibiotics and other kinds of treatments, and also better surveillance of antimicrobial resistance patterns. It sounds like tackling this is going to take a really coordinated effort from all levels of government, health care providers, researchers, and the public. Absolutely. Everyone has a role to play. And this brings us to another really critical area for Foresight that the report highlights strengthening Canada's health workforce. I mean, we've all heard the stories about burnout and shortages in health care. How does this relate to pandemic preparedness? Well, think about it. When you have a health crisis, it's the people who are on the front lines, the doctors, nurses, paramedics, lab technicians. They're the ones putting themselves at risk to keep the rest of us safe. But if we don't have enough trained professionals, or if those professionals are overworked and burnt out, it makes our entire health system more vulnerable. So it's not just about having enough hospital beds and ventilators. It's about making sure we have enough healthy and supported people to staff those beds and use that equipment properly. Exactly. The report really stresses that Canada needs to address those root causes of these health care worker shortages and burnout. We need to invest in education and training. We need to create better working conditions. And we need to deal with the systemic issues that contribute to moral injury and fatigue in the health care professions. I think what's really hit home for me today is that pandemic preparedness is about so much more than just stockpiling N95 masks and ventilators. It's about building a more resilient and more equitable health system overall. I completely agree. And it's also about recognizing that health is not just the responsibility of doctors and nurses and governments. It's a shared responsibility that requires action from all of us. What do you mean by that? What can everyday people do to contribute to a more pandemic resilient future? There's actually quite a lot we can do. Staying informed about potential health risks, making sure we're vaccinated, simple things like practicing good hygiene, being willing to advocate for policies that support public health. These are all important actions we can take as individuals. So it's about being proactive, taking care of ourselves, and also looking out for each other. Exactly. And it's about staying engaged and interested in these conversations. This report is really just a starting point. We need to keep talking about these issues. We need to demand action from our leaders. And we need to work together to create a healthier future for absolutely everyone. What a fantastic note to end on. This has been a really eye-opening deep dive into a very important and complex topic. So thank you so much for joining us on this journey. And a huge thank you to our expert for sharing your incredible insights with us today. It was my pleasure. And for all of you listening, remember the message of this report, the time to act is now. So stay informed, stay engaged, and stay healthy. Until next time.