Tania Bubela and colleagues examine how fragmented responsibilities and accountability for public health data hindered Canada’s pandemic response
Canada’s public health system was reformed after its 2003 severe acute respiratory syndrome (SARS) outbreak, which was the worst outside of Asia with 438 cases and 44 deaths.1 Ensuing national and provincial inquiries led to the creation of the national Public Health Agency of Canada (PHAC) to coordinate Canada’s preparation for and response to public health threats.2 Subnational public health agencies were also created or strengthened to function as regional centres for disease control.1 These actions should have put Canada in a good position to respond to the covid-19 pandemic.34
Despite these reforms, Canada experienced serious failures during the covid-19 pandemic failures. Memories faded rapidly after SARS, and if history is not to repeat itself, government and health system leaders must strengthen the country’s public health and healthcare systems in preparation for the next threat. Health authorities as well as all Canadians need to reflect on the crises of the past three years—what went well and why; what caused pandemic response failures, and what were their consequences? Here, in the first of a series of articles examining Canada’s response and setting out suggestions for a national inquiry, we examine the limitations of the country’s decentralised structure for public health decision making and missed lessons from the 2003 SARS-CoV-1 outbreak, particularly with regard to data infrastructure.5 Other articles in the series examine how research and data failed to inform public health responses tailored to community and population needs,6 the predictable failures in long term care,7 and Canada’s role in global vaccine inequity.8
Canada’s cumulative confirmed covid-19 death rate, as of June 2023, was 1372 per million population, exceeding the global average of 855 per …