Jordan: It’s been more than half a year since the very first warning bells started sounding about a new virus in China. You can be forgiven if you didn’t realize it had been that long, because chances are, you didn’t hear those warnings at first. Or if you did, you probably didn’t take them seriously enough. And hey, as it turns out, neither did most of Canada’s governments. And public health organizations. So you’re in good company sort of. Six months later, of course, the world is changed. And now it’s worth taking a hard look at how prepared for this we could have been, and why we weren’t. And that’s where our guest today comes in, with an unbelievably detailed investigation into who knew what, and when, and who they tried to tell, and who listened, and who didn’t. If you’re disappointed with the way that Canada has handled COVID-19, today we’ll show you exactly where we fell down. And if you’ve actually been largely impressed with how we’ve handled it, that’s fine. We definitely could have done worse. But you might be interested in knowing how much better we could have been if we listened and acted a few weeks earlier. I’m Jordan Heath Rawlings, this is The Big Story. Robyn Doolittle is a reporter on the investigative team at The Globe and Mail, and she and her colleagues dug into everything that happened around the pandemic in Canada, from the moment we first realized it was coming. Hi Robyn.
Jordan: Why don’t you first just describe what you and the team did and how extensive it was? Cause there is a ton here in your report.
Robyn: Sure. I mean, I can start back, I would say, in late March, early April. The investigative team, we were kind of sitting around and talking about this story that I think every journalist was grappling with at that time, is did Canada mess this up? Like, were we on top of this? Is it, I mean, obviously it caught– the pandemic caught countries around the world off guard. So how much blame can you really put on one government for not getting ahead of it. But as we were trying to analyze those different questions, I kind of thought, you know, maybe the best way to do this would just be, why don’t we call all of the smartest people in the country, people who studied Coronaviruses well, before that became a household name, who are infectious disease experts, who are microbiologists, who really understand this stuff, and ask them, like, when did– when were you concerned? What did you do at each step? When did you realize this was going to be as bad as it is today? And that was the premise for the story. So in the end I went through, I think I counted, 37 medical scientific public health experts. And then the team in Ottawa was speaking on the political side and interviewing politicians and their staff. And what we established was two parallel timelines of how this pandemic unfolded from the perspective of the government and from the perspective of the experts. And when you line those two things up, you can really see where the lag times were and when it was reasonable, and when it was unreasonable. There is a point up to which it was reasonable that we were slow. And beyond that, there’s no excuses. That’s kind of what the story is about.
Jordan: Well, tell me about the sort of beginning of those timelines, especially on the scientific side. Like, was there an initial warning bell that was sounded and how early was that? And what did they do?
Robyn: Sure. So almost everyone heard about this situation in Wuhan from the same source. There’s this mailing list, that’s a website also, called pro-med. And it’s just kind of a warning crowdsourced, but vetted site that infectious disease experts look at to track infectious disease updates and popups around the world. And that’s where almost everyone heard about it. That came out on December 30. So that’s end of December, early January. And at the time, all that was reported as there was 27 cases of a mysterious pneumonia in Wuhan that seemed to be connected to a wet market. And so right at that moment, you started to see little groups of experts experiencing this news in different ways. So, you know, I spoke with Bonnie Henry in BC, as well as a doctor there at the BC centre for disease control, who right away were very concerned about this because they had been on the front lines of SARS. Bonnie Henry, you know, led the operational response to SARS in Toronto at the time. And there were details about that initial post that were really concerning, especially in the first couple of days, there started to be rumours that this was a novel Coronavirus. That of course meaning that this is a never before seen in humans virus, and that would mean that no one on the planet would have immunity to it. So you saw right away the kind of splinters happening. In BC the BC centre for disease control sent out three warnings to its healthcare staff, airport staff, emergency room staff about this virus by January eighth, and the public health agency of Canada sends out their first warning through their intelligence system. On January ninth. So it’s not a big deal, but you can start to see it, right? So it started with the pro-med post, and where things started to kind of split was around the middle to end of January. This is when you started seeing cases leaving China. So a case shows up in Bangkok, for example. Some experts that I spoke to said that was the first sign that this was bad. And the reason is that China at the time was saying there was only something like 44 cases and that they all possibly were connected to this wet market. It wasn’t sure if people could actually even spread it between each other. But they said if a case is showing up in another country, you know that there are more cases than 44. Because in a city of 11 million like Wuhan, the idea that one of those people would get on a plane, it’s next to impossible. And this shows us that China’s numbers are not accurate and cannot be trusted. So that was kind of one of the first big red flags. And the other one that happened in January, came around the week of January 20. And this is when the Chinese government shut down Wuhan. It was an unprecedented lockdown of a city of 11 million, soon extended to all of Hubei province, around 60 million people. Chinese New Year celebrations were canceled. This is the biggest holiday in China. And also, the construction crews in Wuhan started building two massive temporary hospitals that were to be completed in a week. And so those were all big red flags for some of the experts that I spoke to that said by the end of January, they were convinced this was going to circle the globe and convinced it was going to be bad because you– to paraphrase one of the experts, you don’t build a temper a hospital in 10 days if it’s not really bad.
Jordan: So what were they saying at that time to Canadian politicians? And what were Canadian politicians doing? Is this the place where it starts to diverge? Because at that time I remember being told that everything was probably fine.
Robyn: Yeah. I actually remember listening to this podcast and hearing, you know, David Fisman who was one of the, you know, the experts that I interviewed for this. And he was saying, you know, in January, there’s absolutely nothing to worry about. And that was a really common sentiment. You know, a lot of the experts that I spoke to by the third or fourth week of January did not think that this was going to be a big deal. They thought this was going to be like SARS.
Jordan: So this is when it’s understandable to not be super alarmed?
Robyn: Yeah, January, there were reasons. And in fact, up until the middle of the February, there were reasons that you could think this was totally appropriate. You know, you asked what our public healthy bodies, what are were saying at the time? The message at the end of January was, there is very low risk of an outbreak in Canada. That was the message repeated coast to coast. We’re watching this, we’ve got this. And this is where I think in hindsight, people think we fell down, in that the guiding principle for public health should be that you hope for the best, but plan for the worst. And sure, there were lots of songs to think that COVID was not going to be what it is today. But we should have anticipated that it could be. And what steps could we have taken at that time to get ahead of this? Ordering testing supplies and protective gear were some big misses that we could have done. And in fact, in my research, I uncovered hospitals where the infectious disease experts on staff were so convinced it was going to be bad that they started stockpiling within their own institutions. But yet the government on mass didn’t. And so that’s why we have, I have these massive shortages right now. I mean, there’s shortages around the world, but Canada could have been in front. The province of Alberta got intelligence in December that the situation and Wuhan might be bad, and they– the province of Alberta started stockpiling protective gear. They started making inquiries the third week of December and placed those orders at the end of January. So that’s an example of planning for the worst, hoping for the best.
Jordan: Were there doctors, outside of the public health system and universities and wherever, actively sending messages to people who have the power to make those plans? And do we know like when that was, and if they got through, even?
Robyn: That is the whole foundation of this story, is reaching out to those experts who are not officially connected to government and to see what they were doing during this. These are the people who are top of their field, lauded around the world. And when I started calling them, yes, they were– the ones who were really concerned, started sending their concerns to government, to the public health agency of Canada, as well as to officials within Ontario. The real story that emerged in one way, I guess, is that Canada did pretty well in this. I mean, we made mistakes. But the big thing is that yeah, didn’t mount our defensive COVID as one nation. We did it as a series of silos within individual provinces, and also within specific institutions, depending on how our healthcare system was structured. So BC has a much more integrated healthcare system than in Ontario. Alberta’s health care system is fully integrated. So every infectious disease expert connected to a hospital is filtered into the government. There’s already chains of communication, there’s a hierarchy, there are, you know, relationships established. In BC there’s the BC centre for disease control. So everyone’s kind of connected in there. There was a lot of consultation and communication. In Ontario, it’s incredibly fragmented. There’s the chief medical officer, there’s the ministry of health, the ministry of longterm care, there’s public health Ontario, there’s Ontario health, which was a new agency established to try to piece together all these disparate little kingdoms, if you will. And it never really got that work going. There were 34 public health units that are all report to local boards, but not to the chief medical officer. The hospitals are all separate and run as their own little entities. It’s a really complicated system. And that left a lot of experts unclear of where to even raise their concerns. So as you mentioned, they did start directly emailing decision-makers. I spoke to, you know, one doctor, Monir Taha, he’s an associate medical officer of health in the city of Ottawa, at Ottawa public health. And he wasn’t really sure where to go. And so he just started sending emails at the end of January that were becoming increasingly agitated to officials within them ministry, public health Ontario, and the chief medical officers, saying we have to get ahead of this. Our plan is not going to work. We need to start preparing our ICUs. We need to be counting ventilators. And he was very good concerned, and wasn’t sure where to send those emails.
Jordan: Was there a time when it went from kind of, you know, being understandable– you mentioned Dr. Fisman was on this podcast and he told me it was fine to travel in February, and nobody really knew what was coming– and then a time when you know, it became negligent to ignore the warnings? Is there anything that the scientists point to as kind of like a moment when we should have flipped our behaviour right away?
Robyn: Yeah. There was one very clear tipping point event. And it actually ties into an example, the main example, I would say, about where the experts and public health and government differed in opinion. So, well, I should start– the federal government and the provinces set guidelines for who could be tested for COVID-19. And it very narrowly focused on people who had been to Wuhan who had symptoms, and then it was later broadened to broader Hubei province, but not the rest of China, even though there was widespread evidence that COVID was spreading throughout China. In British Columbia, they split with the rest of the country and said, doctors could test whomever they wanted, if they were concerned, regardless of travel history. Infectious disease experts, doctors in Ontario wanted that same latitude. They’re saying if we’re only testing for places where we know there are cases, we’re going to miss cases because the virus is spreading. The doctors started, you know, sending emails and letters and asking the government to expand the testing and finally decided to just do it on their own. And when the ministry got wind of this through the Ontario hospital association, they told hospitals they are to stick to the guidelines. What’s really significant is that on February 20, British Columbia announced that they had found a case, a young woman had tested positive for COVID who had no travel history to China. She had only been to Iran recently. This was really significant because Iran had– at the time that BC tested for that case, had no reported cases of COVID. And when BC announced around that time, a couple more cases were reported around the world. Of course, there was a huge outbreak within Iran. And that was the tipping point that every single expert I spoke with said, by the week of February 20 and those couple of days, that’s when everything became clear. It was obvious that this was going to circle the globe, that it was going to be really bad. The reason– I know, I spoke to Dr. Fisman about this– is that the Iran case showed that COVID was spreading the country that had no reported cases. So there is community spread outside of China. And Iran had no infrastructure to try to contain an outbreak like this. So there was no way to kind of stop it. That was the tipping point for every single person that I interviewed that was not connected to government.
Jordan: In an ideal world, according to your experts, what would have happened right then?
Robyn: So I think big things that– I mean, I should say it’s not like all the experts agreed on what needed to be done, right? Like there is– like, that’s part of what the government was dealing with is, sure they were getting emails from experts telling them to do various things, but they were getting pulled in a lot of different directions. But certainly what I heard was a mandatory quarantine for people entering the country. Would have helped because when you look at the virus that’s in Canada, early reports– there’s still work being done on this– but it looks like it came from kind of the United States and Europe. So if people came back from March break and had to stay home for two weeks under the quarantine act, you know, they had to, this wasn’t a voluntary thing, that could have gone a long way. Certainly if we had been buying up testing equipment. So, in Ontario there was a huge backlog of testing, and part of that is because there was shortages of the swabs that you need to take the sample, there’s shortages of one of the solutions to mix the testing. That would have been big. I think a lot of what you also hear is just priming the public for this, talking about social distancing. I mean, we went from telling people that the risk of an outbreak in Canada is low, to saying you can’t go to work for the next year in about two weeks. Like the whiplash of it! The other thing I heard was, you know, it’s hard, because if in January, the government had come out and said, everybody wear masks, we’re going to, you know, close the borders. We’re shutting down businesses. People would have laughed. People would have freaked out. This is all built on trust, what we’re doing right now. But you can people in with kind of calm explanations. And that’s, I think, where people have really struggled with some of the messages coming out of government, is that, you know, it’s fine to change because the science changes. But masks was a big sticking point, where, you know, the public health agency of Canada, Dr. Tam, actually said at one point, like there there’s some suggestions that they can make it worse. So now when you see people not wanting to wear masks, it kind of all stems back to the messaging. Well, weren’t they saying a while ago that it might actually make it worse? Well, now it’s not needed. Now it is. I can’t keep it straight. They’re inconvenient. It’s hot. I don’t want to wear them. So just a consistent messaging, preparing people, quarantine woulda been a big one, figuring out testing, getting hospitals in place. None of the labs were integrated in Ontario. So public health, commercial labs, hospital labs all reported to different sections of the ministry. And that’s part of why our testing backlog got so big. So I know that that’s a whole bunch of stuff kind of thrown at you, but that was a big part of it.
Jordan: I mean, it’s really interesting, trying to piece the entire thing together. And especially when you kind of walk me through the timelines. Because now looking at it in retrospect, right? Like that all feels like three weeks crammed in together because everything was happening. But when you, you kind of think, you know, I came back from a trip on February 16th. I didn’t even think twice. And I was flying through LAX. Yeah, it wasn’t until four weeks later, I guess? Like when did Canada, in terms of governments get really serious about cracking down?
Robyn: It’s nuts. It happened in a span of a couple of days. It’s, you know, it seems to be kind of March 11, March 10, March 11, March 12 is when things started to shift. World Health Organization finally declared COVID a pandemic on March 11, the NBA closed that day, Tom Hanks said he had COVID that day. You know, I know couple days before that I was, you know, fighting with my parents being like, you need to come back from Florida. Like that’s kind of, when everyone was sort of waking up to it. You know, the Prime Minister’s wife, Sophie Trudeau, it was announced she had COVID on the 12th. I mean within a week, the borders were closed to all but US citizens. And then, you know, a couple of days after that, the US followed as well. Which is an extraordinary thing. I mean, that was something else that we uncovered in our reporting is, it was really the Deputy Prime Minister, Chrystia Freeland, who made that happen, ahead of where public health was comfortable going around closing the border with the United States. And border closings are controversial. Not everyone agrees. But I think that that’s one tool in a toolbox that experts think maybe we should have utilized earlier.
Jordan: Speaking of tools in the toolbox, one of the things we kept hearing– you mentioned Dr. Fisman, but we heard it from everybody that we kind of talked to in the early days of this– was that, we’d learned lessons from SARS, and those lessons would help us fight this, and did they? What did you find about how well we followed what we knew?
Robyn: I’m glad you came back to SARS cause I’ve been meaning to find a segue to it. Cause it is so crucial. I think if you want to pinpoint where things really fell apart for us, and for the rest of the world, genetically speaking COVID looks a lot like SARS. As you know, I mentioned Monir Taha, the doctor who was emailing government really early on saying our strategy is not going to work. In his emails he was pointing out that this is not SARS. There’s early indications that this is not SARS. COVID is less deadly than SARS, but it seems to be much more contagious. And that’s what the problem was. We crafted our response to COVID as if it were SARS. And many of the experts I interviewed said, if COVID had been like SARS, we would have been fine. We actually did much better this time round, we would have got ahead of it. The big difference of course, with, with COVID, it seems to be that you are shedding the most virus around the time that you develop symptoms. So either– even in the 48 hours before you start showing symptoms, SARS, you seem to be the most contagious, as I understand it, after you develop symptoms, which is why healthcare workers got it so much. Like, by the time you’re in hospital, that’s when you’re the most contagious. COVID, it’s the opposite, right? Like you’re the most contagious before you really appreciate that you have it, and you see that problem there. Dr. Taha was saying, you know, Canada is trying to tackle this with a containment strategy. So containment means identify every case, isolate that person, trace that person’s context, get all of those people isolated before they can infect someone else. But for containment, he said, you need to have strong border measures and you need to have robust testing, and a really broad definition of testing. Because you need to catch every case for it to work. And we weren’t doing enough at the border. We weren’t doing enough on testing. You know, people were saying early on, we should have been doing temperature screening at the border. And that’s not perfect, but it’s something, right? Like we were asking people to kind of self-identify if they had any symptoms. I spoke to John Conley, who’s one of the most, you know, revered infectious disease experts in the country, and he’s saying, look, everyone here has been to customs. If they say, do you have a cough? Are you going to say yes or no, knowing you might get hung up? A temperature screening would catch those people with fever at the border. The first case in Bangkok, the first case to leave China, was caught with a thermal surveillance at the airport. So it’s those kinds of measures that people were saying if they had been rolled out earlier, if quarantines had been in place, better messaging, better testing, and I think the biggest thing of all is just being okay with overreacting. And if we can go forward too– cause this probably is going to happen again. That’s the scary part. With climate change, with encroaching on animal habitat, is we need to have public health agencies feeling okay about way overreacting for the public good. Even if they pay a political cost. That’s what didn’t happen here, is that bold action.
Jordan: Well, my next question was going to be, and it sounds like you kind of touched on it already, is when you do so many interviews with so many experts, obviously they all have different opinions on what should have been done and when. But were there consistent themes that kept coming up that we need to be prepared for if this comes back in the fall or, if you know, like you said, we find another one?
Robyn: Over again I kept hearing the same thing about, you know, after SARS the big driving point to– I mean, there were commissions, there were inquiries, there were reports all done on SARS.
There’s so many recommendations. And we seem to have repeated a lot of the mistakes, but the big guiding principle was the precautionary principle. You need to err on the side of caution. Especially when you’re dealing with an unknown, deadly pathogen. With SARS, they felt, you know, they didn’t want to set policy until they had scientific proof that this is what needs to do be done. And they’re saying there’s not time for that in an evolving situation with an unknown pathogen. So you need to plan for the worst. And that’s what we just didn’t do here. And I heard that over and over again in interviews, it just seemed like– the chief scientist of Canada said, when I asked her, why do you think people weren’t reacting? And speaking about the public health agency of Canada, she was saying, I don’t know if it’s denial or if it’s, you know, you can never imagine a loved one getting in a car accident or getting cancer or getting shot until it happens. That’s not what you want from public health, right? But I understand why it happens and everyone understands why it happens, because they’re under tremendous pressure not to over– what if they had spent billions of dollars, stockpiling, protective gear and reagents and shutting down the economy and nothing happens? You can imagine the, you know, how much people will be ripped apart for years afterwards because of that. As a society, we need to give our public health agencies the wiggle room and empower them to be bold. As we approach– you said the fall, this is another example where I think a lot of the experts who’d frankly stood a lot to lose in speaking with us professionally, because they, you know, they write grant applications, they’re reliant on these people. But they’re so worried about the fall because they’re saying we wasted February, February was when we could have got ahead of this. And it seems like we’re doing that now as we approach the second wave. And you know, I said, can you give me an example? And, this one infectious disease expert was saying, you know, for example, we need to approach the second wave as if it’s going to be 10 times worse than the first wave. So knowing that, are we preparing as if this is going to be 10 times worse than what happened in March, April, May, June? And the answer is no, right? So he’s saying, how are hospitals can be able to cope for 10 times more patients? In Europe, they have– cities have designated COVID hospitals. So all the patients with COVID are going to one place so they can keep other procedures in an isolated area. I don’t know if they’re saying– I don’t know if that would work here or not, but are we exploring that? Are we looking at building temporary field hospitals, like China had to? If we are, Canada has really brutal winters. If this stretches on, how do those field hospitals cope in the freezing cold? How’s our testing situation? Are we prepared in that way? And that’s where I think it feels like once again, we’re kind of hoping that the second wave isn’t that bad.
Jordan: My last question for you, Robyn, is– cause you mentioned all the reports that were drawn up after SARS. Obviously Canada did not do as badly at handling the first wave as other places in the world, but not as well as some. Is there ever going to be a way to quantify what that cost us? The month of inaction in February and all those little mistakes?
Robyn: Oh God. Who knows? I mean, how many– when you see the headlines about Ottawa passing various spending measures, all I can think of is how are we ever going to pay for this? Not that they shouldn’t be doing it, because of course you need to. But the really scary thing is we could have all this happen and get through it, and another novel virus could pop up at any time. Because we’re not cutting off the source of where these viruses are coming from, we’re not changing our behaviour to leave these animal habitats alone. I think there– I mean, I didn’t ask anybody, so I wouldn’t want to fathom a guess, but the thing I heard over and over again was that the virus seems to have come to Canada later than other countries. And if we had taken action, I mean, we’re not an island. It’s easier for some, a place like a Taiwan or a New Zealand to close things off. But if we had got ahead of this at the end of February, the first week of March, things could have been very different for us. Lives could have been saved businesses, you know, may have been doing better. We’ll never know. What we do know is that if we don’t try to figure out how to fix these mistakes for the next time, we’re going to pay this cost all over again.
Jordan: Well, that is a positive note to end on. Thanks Robyn.
Jordan: Robyn Doolittle of the Globe and Mail. That was The Big Story. If you would like more we’re at thebigstorypodcast.ca. You’ll probably find a lot of COVID episodes there, including the ones that Robyn mentioned. You can also find us on Twitter at @thebigstoryFPN. You can email us at email@example.com. And you can find us in your favourite podcast player. If it lets you, give us a rating, leave us a review, tell us what you think, tell us what we should cover, tell us whatever you want. We’ll read it. Thanks for listening. I’m Jordan Heath Rawlings. We’ll talk tomorrow.
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