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The great PPE panic: How the pandemic caught Canada with its stockpiles down –



This is the fourth in a series of articles looking at some of the lessons learned from the first months of the COVID-19 pandemic and how Canada moves forward.

To hear Minister of Public Services and Procurement Anita Anand describe it, Canada’s effort to supply frontline workers during the pandemic has been a significant — if uneven — success.

“We did procurement like it has never been done before,” said Minister of Public Services and Procurement Anita Anand. “We are in an urgent scramble to secure personal protective equipment and we will not let up until that task is accomplished.”

The federal government, she said, has conducted just under a hundred flights to Canada carrying Chinese personal protective equipment (PPE) and bringing supplies from the U.S. and Europe.

It was a remarkable, last-ditch effort. But could it have been avoided?

Public Services and Procurement Minister Anita Anand listens to a question during a news conference in Ottawa, April 16, 2020. (Adrian Wyld/The Canadian Press)

Dr. Sandy Buchman, president of the Canadian Medical Association, gives Ottawa credit for pulling every lever it could when the need for PPE became critical. “But they wouldn’t have had to scramble to do that if we had adequate stockpiles, and the same goes for medication,” he told CBC News. “We should have maintained and had them available.

“We had a pandemic plan in place but we didn’t actually have things ready. We didn’t have adequate personal protective equipment for frontline health care workers.”

In fact, Canada still doesn’t have the PPE it needs to keep those essential workers safe.

Read more from the series:

Just take a look at the nation’s capital. Thirty out of some 600 Ottawa paramedics are currently reassigned from front-line duties because of a lack of N95 masks, according to their union.

CUPE ambulance rep Jason Fraser told CBC News that when he began as a paramedic during the SARS epidemic in 2003, he and his co-workers were fitted out with state-of-the-art respirators. 

“For 17 years, the gold standard of mask has been the N95 masks,” he said. “And due to a global shortage or difficulty obtaining proper PPE, all of a sudden surgical masks are OK protection.”

Fraser said his members don’t want to work with anything less than N95s and don’t believe they’d be asked to do so were it not for preventable shortages.

He points the finger of blame mainly at the Ontario government. But a shortage of N95s has been an issue in many places across the country.

PPE stock in poor shape

Canada’s pandemic response got off to a rocky start when it came to the basic tools: masks, gowns, gloves and other products.

Canadian PPE stockpile levels were woefully low when the pandemic hit; materials were allowed to expire without being used or even donated, and then ended up in landfills. The Trudeau government was widely criticized for sending 16 tons of PPE to China at a time when the novel coronavirus was still mostly a Chinese problem, and the Public Health Agency of Canada was still mistakenly assessing the risk to Canadians as “low.”

A cargo aircraft delivers medical supplies and protective equipment to Montréal–Mirabel International Airport. (Daniel Thomas/Radio-Canada)

Anand said her department responded to those shortages by fostering the creation of a Canadian PPE industry from scratch.

“Forty-four per cent of our contracts by dollar value are made with domestic manufacturers,” she said.

“This is an incredible effort on behalf of Canadians themselves to protect Canadians. So that is a heartening story and it’s also an important lesson learned.”

It’s a lesson nearly everyone involved in fighting the pandemic agrees has to be learned — if Canada wants to avoid the same experience when the next pandemic hits.

The preppers weren’t prepared

One nation that hasn’t had to worry about PPE is Finland. Its history of Soviet invasion left it with a siege mentality that manifested itself in the construction of a secret network of bunkers stocked with supplies to carry its people through times of war or disaster — including a huge stockpile of masks.

Canada also has a National Emergency Stockpile System (NESS), launched in 1952 at the height of the Cold War and originally intended to help Canada survive a nuclear attack.

Lately, the system’s rationale has changed somewhat. “We began to move away from beds and blankets and increased our holdings of antiviral medications and key treatments,” Sally Thornton of the Public Health Agency of Canada told MPs at a committee hearing in May.

“We do not focus on PPE and that wouldn’t be a major element, because we count on our provinces, within their respective authority, to maintain their stockpile.”

Some MPs found that answer highly unsatisfactory, given that the NESS last year threw out two million N95 masks that had been allowed to expire.

Stockpile ‘completely unready’

“The stockpile system proved completely unready for COVID-19, and the degree of unreadiness goes well beyond the explanation that COVID-19 was was unexpected in terms of its impact and scale,” said Wesley Wark of the University of Ottawa, an intelligence expert who studied the NESS’s response to the pandemic.

“It was clearly underfunded. Cabinet ministers and senior officials have admitted that fact.”

Health Minister Patty Hajdu said in April that “federal governments for decades have been underfunding things like public health preparedness, and I would say that obviously governments all across the world are in the same exact situation.”

Inventory analyst Olivia Ivey organizes a stack of boxed personal protective equipment inside the massive warehouse in Langley, B.C. where the Provincial Health Services Authority receives and distributes millions of pieces of PPE. (Glen Kugelstadt/CBC)

What Hajdu said is true — although her own government closed warehouses and left the stockpile even smaller than it found it. NESS’s annual budget is only about $3 million and both the Harper and Trudeau governments routinely spent even less on it. It has a regular staff of just 18 people.

“But beyond its underfunding,” said Wark, “it basically lacked any kind of strategy as far as I can tell to prepare for an emergency …”

“There was really no planning done to integrate the federal government’s stockpile system with those held by the provinces and territories. It’s not until February — a month into the COVID-19 crisis — [that] the federal government wakes up to the fact that they don’t even know what is held in provincial and territorial stockpiles, nor do provinces and territories know what’s held in the federal stockpile. That points to a basic strategic failure.”

The come-as-you-are pandemic

When March arrived, Wark said, “the stockpile system had to transition into being a kind of portal for trying to get supplies hastily mobilized from domestic suppliers or international sources into Canada and passed on to provinces and territories.

“You know, I think the whole thing was just a desperate scramble. And it didn’t need to have been that way, if proper attention had been paid to the important role that the stockpile system was meant to play.”

A pandemic is a bad time to start shopping for emergency supplies. With COVID-19 engulfing one country after another, Canada found itself competing with dozens of other countries, as well as private U.S. hospital networks, to acquire the most sought-after items. 

Anand said the government has learned that lesson and will ensure that stockpiles of PPE, medicines and other essentials are maintained in future.

Stockpiles alone won’t solve the problem, she said, because PPE products have expiry dates and a major pandemic would at least start to exhaust any stockpile.

“Another part of the puzzle is also to make sure that we’ve got relationships with a diverse range of suppliers who can produce these goods so that we have priority when it comes to making sure that we have that product,” she said.

Unreliable suppliers

Canada’s two main markets for acquiring PPE supplies — the U.S. and China — have been problematic.

China’s PPE market quickly flooded with new companies that previously had been making things like baby toys or auto parts. They began to churn out PPE of wildly varying quality.

In the U.S., President Donald Trump ordered 3M to stop fulfilling contracts to provide N95 masks to other countries, and halted a shipment to Ontario in April. Thanks mainly to dogged resistance to that order by 3M executives, the threat was averted.

Dr. Deborah Birx, White House coronavirus response coordinator, holds a 3M N95 mask as she and U.S. Vice President Mike Pence visit 3M headquarters in Maplewood, Minn., March 5, 2020. (Glen Stubbe/Star Tribune via AP)

But it it all served as a reminder of the risks involved in depending on other countries for essential supplies in a global emergency. Ontario Premier Doug Ford vowed to make his province self-sufficient.

“I’m not going to rely on President Trump,” he said. “I’m not going to rely on any prime minister of any country ever again. Our manufacturing, we’re gearing up and once they start, we’re never going to stop them.”

Anand said she is working to end Canada’s dependence on foreign sources. 

“The strategy from procurement has been to diversify our supply chains to make sure that we are not reliant on one country or one jurisdiction alone,” she said.

“We would very much aim to have domestic production of every item here in Canada.”

That would mean persuading the Canadian manufacturers that switched production over to medical equipment — such as clothing maker Stanfields in Nova Scotia — to stay in the game once the crisis passes.

Mixed messages on masks

The government’s early advice against wearing masks confused many Canadians, who suspected (correctly, as it turned out) that the guidance defied common sense.

That confusion also affected people in the medical field.

“I have been astounded that we are not being told to wear masks,” one occupational therapist told CBC News on March 31, describing conditions at the rehab hospital where she worked. “We are even being told we can’t wear our own masks and will be reprimanded and potentially disciplined for doing so.”

Some Canadian hospitals even had security guards order people to remove masks before they could enter.

A B.C. Ambulance Service paramedic wearing a face shield, an N95 mask and gloves is seen in the ambulance bay outside the emergency department at Royal Columbian Hospital in New Westminster, B.C., April 12, 2020. (Darryl Dyck/The Canadian Press)

Calgary ER physician Joe Vipond told CBC News the government’s position on masks struck him as irrational from the beginning.

“And I see that changing, but boy it’s slow!” he said.

He said that his own province of Alberta was “pretty late to the PPE bandwagon”.

“I know in B.C. on March 25 every single hospital and every single long term care facility were mandated to wear masks in all situations, in order to avoid pre-symptomatic and asymptomatic spread,” he said.

In Alberta, he added, that decision came “a good three weeks after. And so I think a lot of ways we were quite lucky to avoid a lot of transmission within our acute care facilities. That didn’t work out so well for our long term care facilities.

“I know there was one outbreak at the Lloydminster hospital and also in Winnipeg that were blamed on lack of universal masking. There was always a concern about N95, and we were told to be very cautious in our use.”

Vipond blamed the relentless search for cost efficiencies, cheaper vendors and just-in-time delivery for the shortages.

“There is value in having stockpiles and there is value in having your own domestic control over things,” he said. “I’m hoping that we recognize the value of being a masters of our own domain.”

Mike Villenueve, CEO of the Canadian Nurses’ Association, agrees with Vipond about the patchwork nature of PPE access across the country.

“It’s been a story of great success in many places … and the complete opposite in others — you can’t seem to get it, or it’s locked up, or I’m encouraged to not use it because it’s expensive,” he said.

“Our view is that we should err on the side of protecting people, and whatever the cost of an N95 mask is, [it’s] small compared to the cost of a life.”

‘A sense of mistrust’

Villeneuve said the fact that rules on PPE use varied from place to place led nurses to suspect PPE policies were being driven not by the best science but by harsh realities of supply and shortage.

“How come that filters down so differently across 13 jurisdictions, hundreds of employers and different practice settings and so on, when a nurse in a practice setting in Alberta is doing the same thing as a nurse in the same setting in Manitoba?” he said.

“That sort of sets up a sense of mistrust.”

Anand said that it’s up to provinces to set such policies — but she doesn’t rule out the federal government making uniform recommendations. 

She said her department soon will be rolling out new PPE supplier competitions on its supply hub website.

“We have had 26,000 businesses respond to our call out to suppliers, 26,000 businesses wanting to step up and assist in the Team Canada effort,” she said. And while only about 17,000 of those companies are Canadian, Anand argued it “suggests is that there is capacity in the Canadian economy to become self-sufficient in the area of PPE.”

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Canada extends peacekeeping mission despite Security Council loss –



Canada will provide a military transport plane to support United Nations peacekeeping missions for another year despite losing its bid for a temporary seat on the UN Security Council.

Defence Minister Harjit Sajjan’s office confirmed the continued deployment of a CC-130 Hercules in support of UN missions in Africa on Sunday, ending months of speculation about the fate of the mission.

“The Canadian Armed Forces are playing an important role in transporting critical supplies and personnel to support the UN in the region,” Sajjan said in a statement to The Canadian Press.

“We understand the importance of Canada working with our international allies and partners like the United Nations, which is why we have renewed Canadian Armed Forces support for an additional year.”

Trudeau’s promise of peacekeeping troops unfulfilled

The Hercules, which has been based out of Uganda five days per month since August 2019, was one of three signature promises that Prime Minister Justin Trudeau made to the UN when Canada hosted a major peacekeeping summit in November 2017.

Trudeau also promised the UN that Canada would provide a helicopter detachment, which operated in Mali from June 2018 to September 2019. He also pledged a quick reaction force comprised of up to 200 troops, which has yet to be fulfilled.

Many saw the promises as an attempt by the Liberal government to bolster its bid for a two-year seat on the UN Security Council, and there had been questions about the CC-130 after Canada lost to Norway and Ireland on the first ballot in June.

Sajjan also said that the Hercules recently resumed flights to and from Uganda after a four-month suspension due to COVID-19.

“Following a temporary operational pause due to COVID-19, the tactical detachment in Uganda has recently completed a 10-day mission out of Entebbe,” he said. The plane moved about 42 tonnes worth of cargo and 400 passengers, he said.

Hercules deployment is ‘pioneering’: expert

Canadian Forces College professor Walter Dorn, one of Canada’s foremost experts on peacekeeping, welcomed the extension, which he described as “pioneering” since the plane isn’t assigned to one specific UN mission but helps many in Africa.

“It’s a pioneering service,” he said. “The first national contribution for multi-operation air service in UN history, with operations in the Democratic Republic of Congo and South Sudan already serviced and other missions to be added.”

Dorn nonetheless lamented that the Hercules is only available for five days a month, even as he noted that Canada’s overall contribution to peacekeeping remains at an all-time low with 34 police officers and military personnel around the world.

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Canada's new COVID app won't work on older iPhones, Android devices – CP24 Toronto's Breaking News



The federal government’s COVID-19 contact tracing app is facing criticism for its download requirements, which restrict some Canadians from accessing and using the app.

The free “COVID Alert” app, which became available on Friday, is designed to track the location of phones relative to each other, without collecting personal data anywhere centrally.

Users are notified if their phones have recently been near the phone of a person who later volunteers that they have tested positive for COVID-19.

But the app requires users to have Apple or Android phones made in the last five years, and a relatively new operating system.

Christopher Parsons, a senior research associate at Citizen Lab, part of the Munk School of Global Affairs and Policy, says that makes the app inaccessible for older Canadians and other marginalized groups.

“The worst affected by (the pandemic) are Black, Indigenous, people of colour, people who often have a lower socio-economic bracket. Who’s not going to be able to install the application? That same group … that’s a problem,” he said.

Parsons says criticism should be directed at the federal government, not those who designed the app.

He believes the technical aspects of the application, such as its ease of use and its performance in both official languages, has been done well.

“On the technical end, the developers deserve to be congratulated,” he said. “This is a failure of policy. The government should have seen this, I hope someone has, they should have predicted it, I hope someone has, and they should have done something to try and start fixing it.”

The issue of needing an app that works with older smartphones was known from the start, he added.

For a contact tracing app to properly work, he said, it requires 65 to 80 per cent of all Canadians to use it. The current version of the app makes that impossible.

The Treasury Board of Canada Secretariat referred questions about the technical requirements of the app to Google and Apple, but noted the application is only one tool to slow the spread of COVID-19.

It did not address a question about a potential timeline for the issue to be fixed.

Ontario NDP legislator Marit Stiles took to Twitter to share her parents’ frustration in attempting to download the app.

Stiles’ parents, both in their 70s, tried to download the app on their older iPhones, but it didn’t work.

“They’re so frustrated that they can’t download the app, the app won’t work on their phone,” she said in an interview Sunday. “This kind of surprised me.”

Stiles said this raises some concerns about the accessibility for more vulnerable Canadians.

“I think everybody agrees the app isn’t a bad idea,” she said. “We know that elderly folks, seniors, new Canadians, racialized people are the most likely to contract or be affected by COVID-19 … then it might be a bit problematic that the app only works with the fanciest or priciest new phones.”

For now, the smart phone app is only linked to the Ontario health-care system, with the Atlantic provinces set to be the next provinces to link up.

Neither Apple nor Google returned requests for comment on the issue.

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COMMENTARY: Canada's coronavirus response has not been as great as we like to think – Global News



Judging by some polls, Canadians are happy with the way their leaders managed Canada’s response to COVID-19 or with how Ottawa, in particular, has doled out several hundred billion dollars of aid. Or both.

Canadians may regard their country’s response to the lethal virus as good, but the national death toll has surpassed 8,900. And there is statistical evidence aplenty to suggest that when compared with other countries, Canada’s performance is not exceptional. At best, it has been fair to middling.

However, as with so much else, Canada’s habitual fascination with the U.S. and its fixation on events there, seems to be all many Canadians care about.

READ MORE: How Canada’s first long-term coronavirus pandemic projections hold up today

To gain a broader perspective, it might be helpful if Canadians were to crunch some of the numbers published daily on the beautifully presented, somewhat U.S.-centric dashboard run by the medical school at Johns Hopkins University or the dowdier, more internationally-oriented Worldometers website, which is published out of Delaware.

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Canada ranks 23 in deaths and 63 in infections per capita among the 215 places tracked by Worldometers as of Aug. 1. That fares better than the U.K. (3 in deaths; 43 in infections) and the U.S. (10 for both), but also shows Canada has had less success than places such as Germany (40 in deaths; 74 in infections), Finland (62; 93), Poland (73; 97), Ukraine (79; 86), Japan (126; 157), Australia (127; 120), South Korea (137; 155), Malaysia (154; 156), New Zealand (158; 151), Thailand (178; 199), Taiwan (184; 205) and Vietnam (189; 212).

By every statistical measure, Canada has certainly done much better controlling the virus than the U.S. That has apparently been good enough for most Canadians who, according to public opinion surveys, think that their governments have been doing well and are optimistic about the recovery.

Many Canadians are aware that on a per capita basis, about 90 per cent more Americans have died than Canadians.

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Putting aside flattering comparisons with the U.S., Canada has got a lot wrong in its fight against the coronavirus.

Canada’s elder-care facilities are clearly far inferior to the often austere but rigorously clean and well-staffed homes for the aged in countries such as Finland and Norway. Official oversight of many of these institutions in Canada is much less robust.

READ MORE: Young people are causing COVID-19 spikes. But are they solely to blame?

Canada’s response to the pandemic has often been sluggish and confused. For several months, the federal government did not follow through on promises the prime minister had made that travellers would face serious questions about their health at our borders. Ottawa was also very slow to close those borders, made a hash of ensuring sufficient emergency supplies of personal protective equipment (PPE) such as face masks were available for essential workers and went back and forth for weeks about whether it was prudent for Canadians to wear masks when in public.

The federal and provincial governments did little at first to check whether Canadians returning from abroad were adhering to strict quarantine regulations. Compared with most Asian countries, it has had a woeful record in creating contact-tracing teams and contract-tracing apps.

While Canada’s death rate of 237 deaths per 1 million residents is lower than the U.K. (679/1M) or the U.S. (473/1M), it’s pretty high relative to Germany (110/1M), Australia and Japan (8/1M each), to name a few. (This data is also from as of Aug. 1.)

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The same goes for infection rates. Canada has had 3,080 cases per 1 million residents, and while that’s lower than the U.K. (4,464/1M) or the U.S. (14,215/1M), our rate surpasses that of Germany (2,514/1M), Australia (677/1M) and Japan (272/1M).

Coronavirus infecting more young Canadians

Coronavirus infecting more young Canadians

As for testing for the virus, like the U.S. and European countries especially hard-hit by the deadly virus such as Italy, Spain, France, Belgium and the U.K., Canada got off to a feeble and confused start. On the positive side, much more testing has finally been done recently.

There is almost no information available to reliably measure the efficacy of the treasury-backed remedies being tried by the world’s advanced economies to mitigate the staggering financial cost of the pandemic. A scan of news reports from the U.S. and overseas reveal massive amounts of state aid is being forked out, but comparisons are complicated because the formulas and criteria to qualify for these funds vary widely.

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Some European countries, such as Germany, funnel the money through companies, which are then not allowed to lay their workers off. The Canadian approach has often been to hand money directly, with few questions asked, to people who’ve lost their jobs or are students.

Regarding Canada’s economic prospects this year, the International Monetary Fund published a forecast on June 25 that the country’s GDP would contract by 8.4 per cent in 2020, which is slightly worse than the 8.0 decrease that is expected for the U.S., and also the 8.0 per cent average contraction that is expected across all advanced economies.

That the IMF’s gloomy economic prognosis is worse for Canada than for the U.S. is unlikely to draw the same kind of attention that the higher American infection and death rates do. This may be because of the propensity of some Canadians to feel schadenfreude when the U.S. is on the ropes or because casting a much wider net would interfere with the dominant narrative that Ottawa has done a better job meeting the coronavirus challenge than Washington.

Those Canadians giving themselves a slap on the back for how their country has managed the COVID-19 calamity so far should instead be giving their heads a shake.

The much lower infection and death rates reported by many countries overseas and the informed guesses about the global economy in 2020 that have been made by the IMF are a stark reminder that Canadians should not compare themselves so much with their American neighbours.

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Matthew Fisher is an international affairs columnist and foreign correspondent who has worked abroad for 35 years. You can follow him on Twitter at @mfisheroverseas.

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