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Withered public health agency forced to scramble on COVID-19, auditor general finds

OTTAWA — A withered Public Health Agency dithered on pandemic preparedness, the federal auditor general has concluded, leaving officials no choice but to scramble to respond to COVID-19.

OTTAWA — A withered Public Health Agency dithered on pandemic preparedness, the federal auditor general has concluded, leaving officials no choice but to scramble to respond to COVID-19.

And if such a scramble is to be avoided in future, auditor general Karen Hogan found, it's time for an independent review of the eternal Canadian conundrum: why can't all levels of government work together better?

"It seems that agreeing on who will do what and when, who will report what to whom, and who will take the lead is persistently difficult," she wrote in the introduction to three audit reports on the government's pandemic response.

"This is not an efficient way of working, nor is it a productive way to serve Canadians."

Hogan's audits of the Public Health Agency of Canada, Canada Border Services and the departments in charge of billions of support programs provide a sweeping narrative of the Liberal government's reaction from the day a strange new virus was observed in China and over the surreal months that would follow.

On the public health side, Hogan detailed one gap after another that added up to an abyss: Canada didn't see the pandemic coming, underestimated it initially and as late as last November, still lacked the data to fully track or grasp its actual spread. 

"The government cannot ignore long-standing issues — they do not go away," she wrote.

"We will never be able to tell Canadians what would have happened if the preparedness issues had been better addressed before the pandemic hit and if all plans had been updated and tested as they needed to be."

Meanwhile, as public health authorities were rushing to adapt, those working on financial aid programs switched gears as fast as possible to focus on getting help out the door, she found.

The economic programs Hogan reviewed — the Canada Emergency Response Benefit, or CERB, and the wage subsidy — were crafted, executed and delivered with unmatched speed.

They weren't perfect, but the circumstances didn't allow for perfection and ensuring people had the help they needed was worth the risk, Hogan found.

Nevertheless, she said, that doesn't mean the government is off the hook.

Her audits flagged missed chances to make sure the money went where it was most needed. Her CERB audit noted the Canada Revenue Agency could have used existing information on known fraudsters to flag problematic CERB applications.

The wage-subsidy audit noted the agency opted not to audit selected problematic companies.

"Extensive efforts will be required by the government to make sure payments were appropriate and to recover payments that should not have been made."

Employment Minister Carla Qualtrough and Revenue Minister Diane Lebouthillier said that work is already being done, but it is a multi-year plan that needs diving into Canadians' tax returns to try to catch problems.

"Some of them will be very complex, particularly the more sophisticated fraud, which we don't even know yet what that could or may have looked like," Qualtrough said.

The Public Health Agency of Canada set itself up for challenges responding to COVID-19 by failing to fully implement recommendations from previous health emergencies, dating all the way back to the SARS crisis of 2003, Hogan found.

Emergency plans that were supposed to be routinely updated were not. Aging technology was not replaced. Mechanisms to gather and share surveillance data with the world, the government and the provinces were lacking.

Meanwhile, as the novel coronavirus began to spread globally last January, the Public Health Agency failed to do long-term risk assessments to Canada, focusing instead on short-term risks, and kept telling Canadians the risk to Canada was low.

Federal Health Minister Patty Hadju said Canada's actions evolved as the threat itself did. 

"There is a difference between individual health threat and country health-status threat," she said in a news conference after the release of the reports. 

"As we started to see cases rise, that threat assessment was under constant review and every step of the way, we have listened to our public health leaders."

Once Canada was on alert, Canada Border Agency moved fast to help lock down the border, but public health still wasn't up to speed, Hogan found.

Between May 5 to June 30 — well after the border had been closed to all but essential travel — the agency had no idea whether 66 per cent of those who were supposed to quarantine upon arrival were actually doing it.

Fewer than half of those suspected of not following quarantine orders were referred to law enforcement, the audit found.

Hajdu said enforcement has been stepped up since. Evidence suggests since April 2020, when mandatory quarantine, went into effect, there has been 96 per cent compliance with quarantine, she said.

Trouble collecting data on incoming travellers was only one of the gaps in how much federal health officials knew about the spread of COVID-19 in Canada, as the data filtering up from the provinces was also incomplete. Hajdu said that system is improving now as well, thanks to early federal funding allocated to improve data gathering.

In response to Hogan's work, the Public Health Agency said it has begun implementing its own changes with an eye toward having better systems in place within the next two years.

Hajdu said changes are being made with the $690 million in new funds the federal government has already allocated to plug some of the gaps. 

She said there will be a full review of the government's work as a whole, but the pandemic has showcased the broader challenge of how to balance the need to spend on health delivery with the equivalent need to fund the protection of public health. 

The intergovernmental approach required to combat the pandemic has seen Hogan decide to try a novel approach to a future audit of the latest stage of the crisis: how well the national vaccine rollout has worked.

She said she has begun conversations with the provinces to see if they can co-ordinate efforts.

The Liberals are now beginning to cast forward to pandemic recovery and exploring economic stimulus programs designed to get things humming anew.

But in an unrelated audit also released Thursday, Hogan found one tool they might use to do that — infrastructure spending — is already not on track.

Hogan warned that the slow pace of spending and lack of information on results from the government's $188-billion, 12-year infrastructure plan could mean the funding fails to meet the lofty goals the Liberals set for it five years ago.

This report by The Canadian Press was first published March 25, 2021.

Stephanie Levitz, The Canadian Press