There’ve been news stories about it, but you really should see the extraordinary suite of articles and opinion pieces on Canada’s COVID-19 response in The BMJ, the leading British medical trade journal.
It’s two editorials, an opinion piece, and four analyses of different elements of Canadian governments’ response to COVID. The common theme: Justin Trudeau’s government needs to convene an independent national inquiry into the way COVID was handled in Canada.
It’s a theme that’s dear to this newsletter’s heart: I made essentially the same argument here in June. The BMJ package is produced by experts, mostly Canadians representing 13 institutions in six provinces from coast to coast, with vastly more subject-matter expertise than I could bring to bear. Their assessment of Canada’s COVID-19 response is sharply critical. Their incredulity at Trudeau’s refusal to come to terms is palpable. I am only too happy to shine a light on their efforts.
Today’s post lands on the eve of a major cabinet shuffle. Let’s state the stakes clearly, then: It will simply be unacceptable if organizing a COVID inquiry on a reasonably short timeline isn’t at the top of the next health minister’s list of mandate-letter responsibilities.
The BMJ’s lead editorial makes the case crisply and neatly:
Compared with the shambolic UK response and the chaos and divisiveness of its southern neighbour, the US, Canada may seem to have risen to the occasion of covid-19. We wouldn’t know because no pandemic inquiry has been established by its federal government. This is a mistake.
How well did Canada do? The BMJ authors acknowledge Canada had lower death rates and higher vaccination levels than in most other advanced countries. “But this overall impression of adequacy masks important inequalities by region, setting, and demography. A more in-depth and critical analysis is required.”
The analytical stories on four themes fill out the journal’s case. One focuses on the weaknesses caused by federalism: “Pandemic performance varied widely across Canada’s 13 provinces and territories, hampered by inconsistency in decision making, inadequate data infrastructure and sharing, and misalignment of priorities.”
Another looks at the “predictable” catastrophe in long-term care homes for the elderly, where COVID killed more in Canada than in the rest of the world — even though 100 reports in various jurisdictions had described flaws in care-home administration, and even though mortality rates in such centres was already well above global averages before COVID.
The chapter on Canada’s performance in the global response to COVID is devastating. Canada “became one of the most prominent hoarders of the limited global covid-19 vaccine supply,” lead author Adam R. Houston of the University of Ottawa’s Human Rights Research and Education Centre and his colleagues write. Canada’s generous financial contributions to the global Covax vaccine-pooling system were outweighed by its procurement practices, which led to tens of millions of doses rotting unused while low- and middle-income countries were pushed “to the back of the queue.”
“The picture that emerges,” the lead editorial concludes, “is an ill prepared country with outdated data systems, poor coordination and cohesion, and blindness about its citizens’ diverse needs.”
The sense of déjà vu from this diagnosis should be its own warning, they add. After the 2003 SARS outbreak, an expert panel led by the University of Toronto’s David Naylor wrote about “squabbling … dysfunctional relationships among public-health officials” and “an inability to collect and share epidemiological data, and ineffective leadership, which, taken together, held hostage the health of Canadians.”
The authors list five reasons why an independent inquiry is needed now. First, “failing to look at the past will ensure an unchanged future.” I might paraphrase this another way, for a government that is certainly closer to the end of its tenure than the beginning: This is a legacy project. This will inform the way future generations of Canadians judge our generation.
Second, any decision not to convene real experts will let “others” — read, crackpots — fill the void. “A disturbing covid fallout is the growing social and political divisiveness, which is ignored at Canada’s peril.”
Third, the BMJ series’ mostly Canadian authors note forlornly, “an inquiry would help deliver on Canada’s ambition to be a global leader.” Note that this sentiment implies that leadership is not achieved through self-congratulation, but through doing the work.
What’s the government’s response to this broadside, delivered by a broad cross-section of the country’s medical expertise on a prestigious international platform? My colleague Lauren Pelley at the CBC reports that Jean-Yves Duclos’s office said the feds are “committed to a review of the response to COVID-19 in order to take stock of lessons learned and to better inform preparations and responses to future health emergencies.”
I’m not sure what to make of the fact that this response is, word for word, identical to the response I received when I asked about an inquiry six weeks ago. I suppose it’s good that the government remains forever committed to a path it has done nothing to travel.
This might be a good place, though, to send you to an extraordinary Twitter thread about the phrase “committed to…” in politics, written 18 months ago by the political consultant and urban-governance expert Brian Kelcey, who has since gone on to work for Winnipeg’s mayor. To some extent, Brian’s Twitter thread (I’m going to keep calling it Twitter) stands as a bonus chapter of my series on political communications, because it shows how governments come to say, endlessly, things that sound portentous but mean nothing. It really is worth reading.
Or maybe the government of Justin Trudeau really is committed to a review? If so, it’s easy enough to show that commitment. It’s July. There’ll be a new cabinet tomorrow, and new public mandate letters to ministers sometime after that.
Fine: The prime minister must include in his next letter to the health minister a clear instruction to launch an independent experts’ inquiry into Canada’s handling of COVID. Theoretically this government has two more years in it. The expert panel on COVID should be told to report in half that time.
It’s not ideal but it’s better than nothing. And I really believe nothing is what the PM’s people would prefer to see. As I wrote when I raised this subject in early June, “I know this week doesn’t feel like any kind of moment of serenity and opportunity. But some day people will curse us for not making the best use of this time, if we don’t.”
A final note on this newsletter’s comment board: some of you will be tempted to celebrate the stale news that Canada’s COVID performance was less than entirely catastrophic. This is an example of the protection racket our two main political parties are running together, in which each party uses the other as a reason not to smarten up. Feel free to run that racket, I won’t interfere. But I’d prefer to live in a country where our leaders, and their amen corners, were gifted at something besides shifting blame.
I don't like to add stuff I should have written in the original post, but sometimes the comments shake some extra thoughts loose.
(1) 20 years ago — which is not the same as "In ancient Rome," it's practically yesterday — expert inquiries were held into the handling of a pandemic, at both the federal and provincial (Ontario, where SARS mostly happened) levels. It wasn't some astonishing miracle. It seemed reasonable — again, not to our ancestors, but to our slightly younger selves — to look around after a mess and think about how to avoid future messes. I actually don't believe we've lost that mojo, as a species. I believe this sort of behaviour is still possible.
(2) The earlier inquiries had zero effect on electoral outcomes. Most things that happen in politics have zero effect on the next election. People need to stop judging things on the fear that they'll hurt "our team" or the hope that they'll hurt "their team." It's a childish way to see the world. Governments need to govern, or all is lost. That's all.
A reader passed along André Picard's column, which makes a counter-argument:
https://www.theglobeandmail.com/opinion/article-should-canada-conduct-a-national-covid-response-inquiry-the-bmj-thinks/
André basically says, we know what's not working and we need to get on with it. It's appealing.
Briefly, the caveat I'd offer is the early-February federal-provincial meeting on health care, the cruellest parody of executive federalism I've seen in 30 years. Since this is now how health care is managed, I think it's still fair to hope a grownup wanders into the shot, writes down some grownup advice, and holds a news conference to make the advice hard to ignore.