Thanks Paul for sharing the report and also being doggedly determined on this. Your summary offers us the opportunity to have a taste of what's in there. It feels like a report that neither this government or the next is likely to use as a springboard for action. Politics trumping science and serious policy yet again.
Not the best start to a Thanksgiving weekend. I guess the only good thing for you is that they dropped it on Thursday and not late on Friday.
Also, thanks for making this available to unpaid subscribers. I am a paid subscriber, but I share your view that stuff of this crucial nature needs every eyeball possible.
Bravo Paul for determinedly following up on this! We talked about this exercise months ago, so I am glad your efforts finally bore fruit. Despite the weird secrecy around the whole thing, It is a very useful report based on my read. It mirrors some of my own conclusions leading the Manitoba government's pandemic response as Clerk and Cabinet Secretary, particularly on Indigenous health concerns.
Page 81 of the Report states: "The pandemic, however, did spur some jurisdictions to collect and share distinctions-based Indigenous health data. For example, the Manitoba government began collecting First Nations, Métis, and Inuit identifiers in April 2020.159 Individuals who tested positive for COVID-19 were asked to volunteer information about their Indigenous status. This data collection stemmed from the establishment of a data sharing agreement between Manitoba Health and the Assembly of Manitoba Chiefs, which recognized and abided by the principles of First Nations self-governance and data sovereignty (ownership, control, access, and possession)."
We also pushed data boundaries to get a better handle on what we called "COVID hot spots" to see where we had to prioritize vaccine administration in vaccine-resistant populations. The report states on page 79: "For example, the Manitoba government was able to prioritize vaccination by postal code area during the pandemic."
What remains missing for the country is a true Lessons Learned inquiry on how ALL our institutions - not just health and research - performed during COVID times and what we can apply for better governance overall.
“The point is not who is right and who is wrong about airborne transmission. The point is not science, but safety. Scientific knowledge changes constantly. Yesterday’s scientific dogma is today’s discarded fable. When it comes to worker safety in hospitals, we should not be driven by the scientific dogma of yesterday or even the scientific dogma of today. We should be driven by the precautionary principle that reasonable steps to reduce risk should not await scientific certainty.”
Oh wait, that’s from the SARS Commission report two decades ago. Walport is absolutely correct to call out the atrocious science communication from our official scientists. Absence of evidence is not necessarily evidence, yet time and time again the bureaucrats exuded certainty where there was none and had to backtrack.
I closely followed the scientific developments during COVID and was dismayed that our officials were constantly two to six months behind reality. I felt like Cassandra, cursed with the ability to see the future. The outdated and overconfident official advice was not only useless, it was destructive. Normal people could smell a rat. Convoy types and COVID maximalists both railed against official advice. Eventually everyone stopped listening as the bureaucrats retreated to a weird religiosity: “Trust The Science”.
If The Science is ever to be trusted again, official scientists need to tell us what they don’t know just as much as what they do know.
JW I felt the same way throughout. Thanks for putting that into words. How frustrating it was, especially considering we already had a very good post-SARS Pandemic Influenza Plan (co-written by Theresa Tam) from 2004.
My wife works in the public sector (I will be circumspect about where). When she proposes a course of action, the document she prepares must go up every step of the bureaucracy for approval at each level, and then come back in the opposite direction before she can then proceed. (Over the years the number of levels have only increased.) It doesn't matter if there is a pressing deadline, or if the proposal is simple, or anything. There is a deep and profound reluctance to delegate authority. What if the proposal is wrong? What if the CBC reports on it negatively? Better to be safe and do nothing, than be sorry. Efficiency and effectiveness are of no concern.
The problem in not just with Health Canada. The problem is system wide, at all levels of government. Paul interviewed Anita Anand recently about efficiency in the public sector. This is a worthy enterprise. But actually solving the problem is going to be very difficult and painful.
You must have missed the 90s jokes, where it was impossible to purchase a PC without Windows already installed and charged to you. We called it "the Microsoft tax".
And today, with a virtual monopoly on business desktops, it operates much as a government, everybody has to pay. By far Microsoft's largest customers are the three levels of government; about a third of their income is "taxpayer money".
Similarly, the huge inefficiencies in Canadian monopolies and oligopolies (groceries, telecom, banks) because they have captive markets, are a tax upon the whole economy.
My sister was a public sector worker too. She tells how something from above would arrive on their desks as a "priority", and folks would get right on it. Just as ideas were coming together and a plan taking shape, orders would arrive to scrap it, because there was now a new "priority". Over time she says people just lost their enthusiasm, and became unmotivated cynics.
She should have a consultant put their name on her work and then send it up. Consultants are more trusted and, more importantly, are infinite reservoirs for blame.
At a much smaller level I have been involved in similar exercises in my own field but sadly the end results has been despairing. Why? People being what they are with self interest, competing visions, political exigencies etc. The story here is essentially a science one.How many people at senior levels in govt have a science training ? Politicians ? It’s all political survival all the time. We are in an era of I have my facts & you yours which is found at all levels of social status.
In any case Paul , keep on fighting the good fight.
Real public service in digging in and following up on the Walport report and the issues it raised. Shame on the government for the long delays and long weekend drop.
I can't think of a reason for the government to *talk* about their Doing the Right Thing, it gets them only pain, and almost no credit.
Economists agree the carbon tax was the Right Thing, and most journalists note that, while still calling it a "political" failure and election-loser.
Health care economic experts agree that pharmacare and dental care are the Right Thing, every dollar spent saving two or more, but as Pharmacare is enacted, the talk is about Trudeau's cabinet woes.
Based on worldometers stats, Canada had not just far, far better pandemic outcome than the USA or UK, but better than all of Europe save Denmark - a factoid almost nobody knows, because that good news is not news. It would be fair to do an international study on why Canada was so much better.
After 3 or 4 beatings, you learn to not be the visibly-smart kid in school; after 3 or 4 political beatings, the Liberals have been painfully taught to do that Right Thing as quietly as possible.
Good point. In Quebec, Legault (once he recovered from his stun-f*¢k like every other politician) did get on it quickly and efficiently. That alone kept him re-elected over a couple of cycles.
Thanks for informing us that this report was published and the lack of government communications around it's release as well as the lack of any plan to execute on any of the recommendations. Scary that any government would think this report is something to be ignored.
Thank you Paul, your efforts are very much appreciated. I anticipate yelling, desk pounding and in response a flurry of announcements timed to have effect after the election.
Personally I think that the public view of maintaining privacy will depend on their view of the honesty and integrity of the political party in power whenever the question becomes important. Which I wish all Canadian politicians and their partisans would take more note of.
I agree in general, but as a matter of evaluation of some of the recommendations, is there measurable evidence that the German and Australian data systems let them handle the crisis any better than anyone else did?
Excellent question. But a better one is will the data allow them to handle future crises better. I can't imagine how having more and more accurate data would lead to worse outcomes.
I believe there is some evidence that having more data does not lead to better decisions. I associate this idea with Gerd Gigerenzer’s book Gut Feeling.
...sort the nations on "deaths/million" for the way I measured the final "contest" I called "The COVID Cup" - who beat whom at not-dying.
Canada, at 1500ish, was about the same as Denmark and Norway, far lower than the rest of Europe, including Germany (2000).
Australia was down around 700, in league with actual islands like Taiwan and South Korea (it's an island, considering the north border).
So I think that "being an island" was better than "data systems". The USA and UK had pretty good tech and data, but were just the worst, at over 3600.
Your pandemic superstars were communists, like Vietnam and Cuba; public health doctors came by to test, and any positives got the whole family a visit to an unused hotel. (Soldiers backing up the order.) Cuba was untouched until Delta blew through every protection in summer 2021 - by which time Cuba's THREE home-brewed vaccines were being frantically dispensed at jaw-dropping speed. The did the population in about 6-8 weeks, and the pandemic "wave" just fell off a cliff. I felt like applauding. My blog did:
Keeping in mind that the pandemic manifested itself in different ways in different countries. Australia and New Zealand had hardly any cases when they effectively banned entry for several months, but cases shot up when those bans were lifted and, I suspect, Australians and New Zealanders likely have had as many per capita covid cases as anyone. I'd like to know the effects of hospital access in various countries, keeping in mind (a) places where medicine is provided by women and non-accredited practitioners exist, and (b) many places can't or won't keep and release accurate stats.
Perhaps only peripherally related, researchers in Germany studied the effectiveness of the novavax vaccine in something like real time, and over a period of months. I don't know the study's population size except that it was large enough to earn the respect of professionals. It would be worth knowing what data base those researchers had access to. Also, in Australia, there was one moment in late pandemic when the government issued what seemed to be, for them, a surprising public health order.
Maybe they knew something at a population level? These would be easy-enough examples to follow up on.
That would still leave the question of who would manage such information - there were many times during the pandemic when I wished for a more useful body than the Public Health Agency of Canada, and probably that wouldn't have been entirely their fault. Who will rid us of this mess?
"See how easy it is to communicate when you’re not getting communications advice?” Maybe he can just be confident that his response isn't going to met with the level of sarcasm, belittling, overwrought headlines, and grandstanding that politicians have to brace for. Seriously. It's not a fair comparison.
I think there's degrees of PTSD with most of us post-pandemic, and politicians maybe more than most, especially the ones who didn't try to brazen it out, like Boris Johnson, but just had to grapple with what they were facing.
We are in so much trouble if Avian flu takes off or some other nasty thing comes along. This piece goes a long way to show how federalism and the toxic political environment might very well kill a lot of people. Though things might change in a real Black Death, "Bring out your dead!" experience, don't be too sure.
Nice piece. My favorite line: “See how easy it is to communicate when you’re not getting communications advice?”
Thanks Paul for sharing the report and also being doggedly determined on this. Your summary offers us the opportunity to have a taste of what's in there. It feels like a report that neither this government or the next is likely to use as a springboard for action. Politics trumping science and serious policy yet again.
Not the best start to a Thanksgiving weekend. I guess the only good thing for you is that they dropped it on Thursday and not late on Friday.
Also, thanks for making this available to unpaid subscribers. I am a paid subscriber, but I share your view that stuff of this crucial nature needs every eyeball possible.
Bravo Paul for determinedly following up on this! We talked about this exercise months ago, so I am glad your efforts finally bore fruit. Despite the weird secrecy around the whole thing, It is a very useful report based on my read. It mirrors some of my own conclusions leading the Manitoba government's pandemic response as Clerk and Cabinet Secretary, particularly on Indigenous health concerns.
Page 81 of the Report states: "The pandemic, however, did spur some jurisdictions to collect and share distinctions-based Indigenous health data. For example, the Manitoba government began collecting First Nations, Métis, and Inuit identifiers in April 2020.159 Individuals who tested positive for COVID-19 were asked to volunteer information about their Indigenous status. This data collection stemmed from the establishment of a data sharing agreement between Manitoba Health and the Assembly of Manitoba Chiefs, which recognized and abided by the principles of First Nations self-governance and data sovereignty (ownership, control, access, and possession)."
We also pushed data boundaries to get a better handle on what we called "COVID hot spots" to see where we had to prioritize vaccine administration in vaccine-resistant populations. The report states on page 79: "For example, the Manitoba government was able to prioritize vaccination by postal code area during the pandemic."
What remains missing for the country is a true Lessons Learned inquiry on how ALL our institutions - not just health and research - performed during COVID times and what we can apply for better governance overall.
Thanks, David. This all started, for me, with that IoG/IRPP conference.
I particularly liked this passage:
“The point is not who is right and who is wrong about airborne transmission. The point is not science, but safety. Scientific knowledge changes constantly. Yesterday’s scientific dogma is today’s discarded fable. When it comes to worker safety in hospitals, we should not be driven by the scientific dogma of yesterday or even the scientific dogma of today. We should be driven by the precautionary principle that reasonable steps to reduce risk should not await scientific certainty.”
Oh wait, that’s from the SARS Commission report two decades ago. Walport is absolutely correct to call out the atrocious science communication from our official scientists. Absence of evidence is not necessarily evidence, yet time and time again the bureaucrats exuded certainty where there was none and had to backtrack.
I closely followed the scientific developments during COVID and was dismayed that our officials were constantly two to six months behind reality. I felt like Cassandra, cursed with the ability to see the future. The outdated and overconfident official advice was not only useless, it was destructive. Normal people could smell a rat. Convoy types and COVID maximalists both railed against official advice. Eventually everyone stopped listening as the bureaucrats retreated to a weird religiosity: “Trust The Science”.
If The Science is ever to be trusted again, official scientists need to tell us what they don’t know just as much as what they do know.
Paywalled but the headline says most of it https://www.bloomberg.com/opinion/articles/2024-10-09/michael-osterholm-how-scientists-and-public-health-officials-can-build-trust
JW I felt the same way throughout. Thanks for putting that into words. How frustrating it was, especially considering we already had a very good post-SARS Pandemic Influenza Plan (co-written by Theresa Tam) from 2004.
Great work following up. Oh, to go back to the halcyon days of 2015 and “open by default.”
Superb reporting Paul. When did burying reports that recommend hard choices become the preferred COAs for Canadian governments?
My wife works in the public sector (I will be circumspect about where). When she proposes a course of action, the document she prepares must go up every step of the bureaucracy for approval at each level, and then come back in the opposite direction before she can then proceed. (Over the years the number of levels have only increased.) It doesn't matter if there is a pressing deadline, or if the proposal is simple, or anything. There is a deep and profound reluctance to delegate authority. What if the proposal is wrong? What if the CBC reports on it negatively? Better to be safe and do nothing, than be sorry. Efficiency and effectiveness are of no concern.
The problem in not just with Health Canada. The problem is system wide, at all levels of government. Paul interviewed Anita Anand recently about efficiency in the public sector. This is a worthy enterprise. But actually solving the problem is going to be very difficult and painful.
I laboured in the vinyards of municipal service back to 1986 and was told then of the three rules to remember:
1) You will not be rewarded for success;
2) You will be punished for failure;
3) "Doing nothing new" is not "failure".
NB: The rules apply to large private firms that have aged into bureaucracy, equally well. Microsoft of the 21st C is not the Microsoft of the 20th.
At least Microsoft isn't operated with taxpayer money.
You must have missed the 90s jokes, where it was impossible to purchase a PC without Windows already installed and charged to you. We called it "the Microsoft tax".
And today, with a virtual monopoly on business desktops, it operates much as a government, everybody has to pay. By far Microsoft's largest customers are the three levels of government; about a third of their income is "taxpayer money".
Similarly, the huge inefficiencies in Canadian monopolies and oligopolies (groceries, telecom, banks) because they have captive markets, are a tax upon the whole economy.
My sister was a public sector worker too. She tells how something from above would arrive on their desks as a "priority", and folks would get right on it. Just as ideas were coming together and a plan taking shape, orders would arrive to scrap it, because there was now a new "priority". Over time she says people just lost their enthusiasm, and became unmotivated cynics.
She should have a consultant put their name on her work and then send it up. Consultants are more trusted and, more importantly, are infinite reservoirs for blame.
At a much smaller level I have been involved in similar exercises in my own field but sadly the end results has been despairing. Why? People being what they are with self interest, competing visions, political exigencies etc. The story here is essentially a science one.How many people at senior levels in govt have a science training ? Politicians ? It’s all political survival all the time. We are in an era of I have my facts & you yours which is found at all levels of social status.
In any case Paul , keep on fighting the good fight.
Paul, vous avez travaillé dur là-dessus et je vous en remercie.
Real public service in digging in and following up on the Walport report and the issues it raised. Shame on the government for the long delays and long weekend drop.
I can't think of a reason for the government to *talk* about their Doing the Right Thing, it gets them only pain, and almost no credit.
Economists agree the carbon tax was the Right Thing, and most journalists note that, while still calling it a "political" failure and election-loser.
Health care economic experts agree that pharmacare and dental care are the Right Thing, every dollar spent saving two or more, but as Pharmacare is enacted, the talk is about Trudeau's cabinet woes.
Based on worldometers stats, Canada had not just far, far better pandemic outcome than the USA or UK, but better than all of Europe save Denmark - a factoid almost nobody knows, because that good news is not news. It would be fair to do an international study on why Canada was so much better.
After 3 or 4 beatings, you learn to not be the visibly-smart kid in school; after 3 or 4 political beatings, the Liberals have been painfully taught to do that Right Thing as quietly as possible.
Good point. In Quebec, Legault (once he recovered from his stun-f*¢k like every other politician) did get on it quickly and efficiently. That alone kept him re-elected over a couple of cycles.
Thanks for informing us that this report was published and the lack of government communications around it's release as well as the lack of any plan to execute on any of the recommendations. Scary that any government would think this report is something to be ignored.
Thank you Paul, your efforts are very much appreciated. I anticipate yelling, desk pounding and in response a flurry of announcements timed to have effect after the election.
Personally I think that the public view of maintaining privacy will depend on their view of the honesty and integrity of the political party in power whenever the question becomes important. Which I wish all Canadian politicians and their partisans would take more note of.
I agree in general, but as a matter of evaluation of some of the recommendations, is there measurable evidence that the German and Australian data systems let them handle the crisis any better than anyone else did?
Excellent question. But a better one is will the data allow them to handle future crises better. I can't imagine how having more and more accurate data would lead to worse outcomes.
I believe there is some evidence that having more data does not lead to better decisions. I associate this idea with Gerd Gigerenzer’s book Gut Feeling.
https://www.worldometers.info/coronavirus/
...sort the nations on "deaths/million" for the way I measured the final "contest" I called "The COVID Cup" - who beat whom at not-dying.
Canada, at 1500ish, was about the same as Denmark and Norway, far lower than the rest of Europe, including Germany (2000).
Australia was down around 700, in league with actual islands like Taiwan and South Korea (it's an island, considering the north border).
So I think that "being an island" was better than "data systems". The USA and UK had pretty good tech and data, but were just the worst, at over 3600.
Your pandemic superstars were communists, like Vietnam and Cuba; public health doctors came by to test, and any positives got the whole family a visit to an unused hotel. (Soldiers backing up the order.) Cuba was untouched until Delta blew through every protection in summer 2021 - by which time Cuba's THREE home-brewed vaccines were being frantically dispensed at jaw-dropping speed. The did the population in about 6-8 weeks, and the pandemic "wave" just fell off a cliff. I felt like applauding. My blog did:
http://brander.ca/c19#venceremos
...when Omicron came, it was already beaten.
Well-done!
Keeping in mind that the pandemic manifested itself in different ways in different countries. Australia and New Zealand had hardly any cases when they effectively banned entry for several months, but cases shot up when those bans were lifted and, I suspect, Australians and New Zealanders likely have had as many per capita covid cases as anyone. I'd like to know the effects of hospital access in various countries, keeping in mind (a) places where medicine is provided by women and non-accredited practitioners exist, and (b) many places can't or won't keep and release accurate stats.
Perhaps only peripherally related, researchers in Germany studied the effectiveness of the novavax vaccine in something like real time, and over a period of months. I don't know the study's population size except that it was large enough to earn the respect of professionals. It would be worth knowing what data base those researchers had access to. Also, in Australia, there was one moment in late pandemic when the government issued what seemed to be, for them, a surprising public health order.
Maybe they knew something at a population level? These would be easy-enough examples to follow up on.
That would still leave the question of who would manage such information - there were many times during the pandemic when I wished for a more useful body than the Public Health Agency of Canada, and probably that wouldn't have been entirely their fault. Who will rid us of this mess?
"See how easy it is to communicate when you’re not getting communications advice?” Maybe he can just be confident that his response isn't going to met with the level of sarcasm, belittling, overwrought headlines, and grandstanding that politicians have to brace for. Seriously. It's not a fair comparison.
I think there's degrees of PTSD with most of us post-pandemic, and politicians maybe more than most, especially the ones who didn't try to brazen it out, like Boris Johnson, but just had to grapple with what they were facing.
Fair comment, Miranda.
We are in so much trouble if Avian flu takes off or some other nasty thing comes along. This piece goes a long way to show how federalism and the toxic political environment might very well kill a lot of people. Though things might change in a real Black Death, "Bring out your dead!" experience, don't be too sure.
“I’m not dead.”
“You will be soon.”