Monday 4 May 2020

The Severity of the COVID-19 Pandemic is Not Unprecedented and Was Predicted by Health Canada In Reports Issued in 2006, 2009, 2015 and 2018

It is hard to accept the statements by Health Canada that  the current pandemic is unprecedented and could not have been predicted, when the Spanish Flu resulted in a higher number of deaths in Canada than the current COVID-19 pandemic and when Health Canada’s own publications predicted what would happen.

It is generally accepted that the 1918  Spanish Flu killed 30,000 to 50,000 Canadians.  Canada’s population in 1918 was about 8 million.  Today Canada’s population is 37 million, about four and a half times higher than in 1918.  The COVID-19 pandemic will have to kill 130,000 to 225,000 Canadians to be proportionally  as deadly as the Spanish Flu pandemic.   If the federal and provincial governments increase their efforts the current pandemic should not kill  more than ten thousand Canadians.   Accordingly, it is hard to accept statements such as those made by Deputy Chief Public Health Officer Howard Njoo on Friday, May 1st that the size of the current pandemic is unprecedented in Canada. 

Not only is the size of the current pandemic not unprecedented, it was actually predicted in a number of federal government publications issued by Health Canada.   Dr. Theresa Tam and Karen Grimsrud were the Co-Chairs of the The Canadian Pandemic Influenza Plan for the Health Sector, 2006 (“Canada’s Pandemic Plan”) , which contains the following statements:

“The next pandemic virus will be present in Canada within 3 months after it emerges in another part of the world, but it could be much sooner because of the volume and speed of global air travel.  ...  Given the increase, different patterns and speed of modern travel, a  new virus once arriving in Canada could spread quickly in multiple directions throughout the country. ... The first peak of illness in Canada could occur within 2 to 4 months after the virus arrives in Canada. The first peak in mortality is expected to be approximately 1 month after the peak in illness.”

That is what happened.

Health Canada also prepared a report following the 2009 H1N1 pandemic entitled ‘Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic’  which mentions that Canada’s Pandemic Plan was based on a ‘moderately severe scenario’  where  “in the absence of a pandemic vaccine and antivirals, it is  estimated that between 15 and 35 percent of Canadians could become ill, 34,000 to 138,000  individuals may need to be hospitalized, and between 11,000 and 58,000 deaths could occur.”   That moderately severe scenario is what is happening now!  It is unfortunate that all actions recommended in Canada’s Pandemic Plan were not followed.

In addition Health Canada distributed a publication in 2015 (updated in 2018)  entitled ‘Canadian Pandemic Influenza Preparedness: Planning Guidance for the  Health Sector” which mentions:

•  The next pandemic could emerge anywhere in the world and at any time of year.
•  There may be no lead time before the novel virus reaches Canada.
•  The first peak of illness in a geographic area within Canada could occur within weeks of first detection  of the novel virus in that area. The first peak in mortality is expected to be several weeks after the peak in illness

How could Health Canada have been taken by surprise by the speed of the COVID-19 pandemic when Health Canada’s own publications predicted what would happen?  Further, how can officials at Health Canada not be aware of the severity of the Spanish Flu and when Health Canada's own publications provide the death toll from the Spanish Flu?  Canada's Pandemic Plan contains the statements that "Historic evidence suggests that pandemics have occurred three to four times per century." and that the worst pandemic was the Spanish Flu that occurred  "during 1918-1919, killed an estimated 30,000 to 50,000 people in Canada and 20 to 50 million people worldwide."  Those statements are repeated in the Health Canada's 2015 and 2018 publications.

Christopher Brett
Ottawa, Ontario

References and Suggested Reading

Anonymous, 2010
Lessons Learned Review: Public Health Agency of Canada and Health Canada Response to the 2009 H1N1 Pandemic.  November, 2010
https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/about_apropos/evaluation/reports-rapports/2010-2011/h1n1/pdf/h1n1-eng.pdf

Anonymous, 2015
Canadian Pandemic  Influenza Preparedness: Planning Guidance for the  Health Sector.  Health Canada, 60 pages
https://www.phac-aspc.gc.ca/cpip-pclcpi/assets/pdf/report-rapport-2015-eng.pdf

Anonymous, 2018
Canadian Pandemic  Influenza Preparedness: Planning Guidance for the  Health Sector.  Health Canada, 64 pages
https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/cpip-pclcpi/assets/pdf/report-rapport-02-2018-eng.pdf

Tam, Theresa and Grimsrud, Karen,  2006
The Canadian Pandemic Influenza Plan for the Health Sector, 2006 (“Canada’s Pandemic Plan”).
Health Canada.  550 pages

Walsh, Marieke, 2020
Trudeau concedes PPE stockpile fell short, NDP charges a ‘breach of duty’. The Globe and Mail Published May 1, 2020
https://www.theglobeandmail.com/politics/article-trudeau-concedes-ppe-stockpile-fell-short-ndp-charges-a-breach-of/
“One of the country’s top health officials argued that the size of the pandemic was unprecedented and the stress it would put on international supply chains couldn’t be anticipated. ... Deputy Chief Public Health Officer Howard Njoo said Friday the current pandemic is unprecedented in Canada.” [Friday was May 1]

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