The COVID-19 pandemic exposed significant gaps in Canada's preparedness for major infectious disease outbreaks. Despite previous pandemic plans developed after SARS and H1N1, the country struggled with testing capacity, personal protective equipment shortages, unclear federal-provincial coordination, and public health infrastructure weakened by years of underfunding. As the acute phase recedes, attention turns to building a more robust national pandemic strategy that can better protect Canadians from future threats. This requires learning from recent experience while addressing the structural challenges that undermined our response.
Lessons from COVID-19
Preparedness Gaps
Despite pandemic plans on paper, Canada entered COVID-19 unprepared. The National Emergency Strategic Stockpile, which should have contained supplies for rapid deployment, had been allowed to deteriorate—masks and other PPE had expired or been disposed of. Testing capacity was inadequate for the scale of outbreak that emerged. Surge capacity in healthcare systems was limited. Plans that existed had not been tested, updated, or resourced.
Coordination Challenges
Health is primarily provincial jurisdiction, but pandemics cross borders and require national coordination. Canada's response revealed tensions in federal-provincial relations—disputes over data sharing, inconsistent public health measures across provinces, competition for scarce supplies, and unclear lines of authority. The Public Health Agency of Canada's role relative to provincial public health agencies proved less clear than needed in crisis.
Vulnerable Populations
COVID-19 struck hardest among those already marginalized. Long-term care residents died in disproportionate numbers, revealing chronic underfunding and understaffing of elder care. Indigenous communities faced heightened risks with limited health infrastructure. Racialized communities experienced higher infection and mortality rates. Low-wage workers in essential jobs could not protect themselves through remote work. The pandemic exposed and exacerbated existing inequities.
Public Communication
Effective pandemic response requires public trust and compliance with public health guidance. Evolving scientific understanding led to changing recommendations that confused many. Misinformation spread through social media. Political polarization turned public health measures into partisan battlegrounds. Maintaining public trust through clear, consistent, and honest communication proved challenging.
Elements of a National Strategy
Surveillance and Early Warning
Detecting emerging threats before they become pandemics enables earlier, more effective response. National surveillance systems must monitor for novel pathogens domestically and track developments internationally. Integration with global surveillance networks provides early warning of emerging diseases abroad. Investment in wastewater surveillance, syndromic surveillance, and genomic monitoring can provide early signals of outbreaks.
Robust Stockpiles
Maintaining stockpiles of critical supplies—PPE, medications, vaccines when available, medical equipment—enables rapid response before supply chains can deliver. Stockpiles must be regularly inventoried, rotated to prevent expiration, and maintained at levels adequate for credible worst-case scenarios. Clear governance must establish responsibility for stockpile maintenance and deployment.
Healthcare Surge Capacity
Pandemics can overwhelm healthcare systems operating at normal capacity. Surge planning must identify how hospital beds, intensive care, and staffing can be expanded during crises. This may involve flexible physical spaces, trained reserve personnel, and protocols for deferring non-urgent care. Building surge capacity requires investment beyond day-to-day needs.
Public Health Infrastructure
Strong public health infrastructure—at local, provincial, and federal levels—is the foundation of pandemic response. This includes adequate staffing, laboratory capacity, epidemiological expertise, and data systems. Years of public health funding cuts left systems weakened when COVID-19 arrived. Rebuilding and sustaining public health capacity is essential for future preparedness.
Domestic Production Capacity
COVID-19 revealed vulnerability when global supply chains for PPE, tests, and vaccines proved inadequate. Canada's limited domestic production capacity meant dependence on imports when every country was competing for the same supplies. Building or maintaining domestic capacity for critical medical supplies—even if more expensive than importing during normal times—provides security against supply disruptions.
Research and Vaccine Development
Canada's vaccine research capacity enabled contributions to COVID-19 vaccine development, but the country lacked domestic manufacturing capacity and was dependent on imported vaccines. Investment in vaccine research, development, and manufacturing capacity would enable faster access to vaccines in future pandemics and reduce dependence on other countries' decisions.
Governance and Coordination
Federal-Provincial Roles
Clarifying federal and provincial roles in pandemic response—before the next crisis—is essential. While respecting provincial health jurisdiction, clearer authority for national coordination, data sharing, and standard-setting could improve response coherence. Intergovernmental agreements, federal emergency powers, or constitutional clarification might be considered.
Chief Public Health Officer Authority
The Chief Public Health Officer of Canada's role proved ambiguous during COVID-19—an advisor without direct authority over provincial public health or even consistent federal support. Strengthening this office's authority, independence, and resources could improve national public health leadership.
Data and Information Sharing
Fragmented data systems hampered COVID-19 response. Inconsistent definitions, reporting delays, and data not shared across jurisdictions limited situational awareness. National data standards, interoperable systems, and agreements on sharing are needed to ensure decision-makers have timely, accurate information.
Equity Considerations
Protecting Vulnerable Populations
Pandemic planning must specifically address populations at heightened risk—elders, immunocompromised individuals, those in congregate settings, essential workers, and communities facing socioeconomic barriers to protection. Equity considerations should be embedded in surveillance, resource allocation, and communication strategies.
Indigenous Health
Indigenous communities face distinct pandemic risks and have rights to self-determination in health. Pandemic planning should be developed in partnership with Indigenous governments and organizations, ensuring culturally appropriate approaches and adequate resources for Indigenous health systems.
Workers and Workplaces
Workplace transmission drove COVID-19 spread, particularly in sectors with close contact and workers unable to stay home. Pandemic strategy must address occupational health, paid sick leave to enable isolation, and workplace safety standards that protect workers from infection.
Maintaining Readiness
Sustained Investment
Pandemic preparedness requires ongoing investment, not just post-crisis funding that fades as memories do. After SARS, investments in pandemic preparedness gradually eroded as other priorities competed for funding. Mechanisms to sustain preparedness investment—dedicated funding streams, regular audits, accountability reporting—can help maintain readiness between crises.
Regular Testing and Exercises
Plans that are not tested may fail when needed. Regular exercises—tabletop simulations, field exercises, full-scale drills—identify gaps and build capacity. Exercises should involve all levels of government and key private sector partners.
Plan Updates
Pandemic threats evolve. Plans must be regularly updated to reflect new scientific understanding, emerging pathogens, and lessons from outbreaks elsewhere. Static plans become obsolete; living documents that are continuously improved remain relevant.
Questions for Further Discussion
- How should authority and responsibility for pandemic response be allocated between federal and provincial governments?
- What level of domestic production capacity for medical supplies and vaccines should Canada maintain, given cost implications?
- How can pandemic preparedness investments be sustained over time without the urgency of an active crisis?
- What accountability mechanisms should ensure that pandemic plans are maintained and updated?
- How should equity considerations be embedded in pandemic strategy to protect those most vulnerable?