Have a voice in post-pandemic planning

We are fast approaching a full year since our college and university swiftly shifted to remote learning and work. I continue to be amazed and impressed by our team’s resiliency and commitment. Now, as we begin to contemplate what a return to our workplace will look like post-pandemic, we have the opportunity to put some thought into how we work, and the many things we have learned this past year.

I hope you will take part in the USask work to plan our return, the Post-Pandemic Shift Project. An opportunity to participate in this work was provided in an email from President Peter Stoicheff last week. This first step is to answer one simple question from your perspective and based on your preferences and ideas. If you haven’t already done this, you can answer that question at this survey link.

Our college will be guided by the university’s work in this area for our campus-based activities. Of course, on the clinical side of our work, as always those in these settings will need to be aware of changes and requirements in the clinical setting now and going forward.

While this has been a challenging and difficult time unlike anything we’ve ever experienced, it has given us some opportunities to rethink our approach to how we work from many angles, including efficiency and flexibility.

Also helping to inform next steps was the second pandemic survey, issued in late 2020. The results of that survey show that our overall engagement results are quite favorable, and given the many challenges we are living through, this is great news. A really positive area for us is that 77% of those from the CoM who responded to the survey indicated their people leader cares about them as a person. This is a really great measure for supporting the engagement of our team and for creating a positive work environment.

In this second survey we are continuing to see that people would like a combination of working remotely and at the office/on campus in the future. Broad themes included under what USask has done well in response to COVID-19 include ongoing communication and updates campus-wide, the careful and thoughtful response that prioritized the safety of employees and students, and the efforts in supporting and accommodating the needs of staff, learners and faculty. Survey respondents indicated that they would like more clarity and detail on what the post-pandemic USask will look like and to have ongoing support and assistance (financial and otherwise) for remote work.

While overall participation was down somewhat compared to the first survey, it was still good and will help guide planning. I would encourage you to visit the website and participate in the above Post-Pandemic Shift Project survey so that your voice is included as we plan together for the future at our college and university.

As we work with the university on post-pandemic plans, we will continue to keep you informed.

Black History Month, books, and February in Saskatchewan

In a number of blogs over the years, I have talked about what I am reading and in return many of you have been generous in sharing books you have found inspiring and/or entertaining. As part of an annual goal-setting exercise, I plan to read 25 books this year—I read a lot, just not fast!

But usually this time of year is when I get the most reading done, and so far I have read four books: Factfulness, by Hans Rosling et al, on how the world is actually improving in many ways; Morality, by Jonathan Sachs, a work of moral philosophy; Leadership in Turbulent Times, by Doris Kearnes Goodwin, a comparative history of the leadership of four American presidents; and Caste: The Origins of Our Discontents, by Isabel Wilkerson, which as written on the cover, is about “how America today and throughout its history has been shaped by a hidden caste system, a rigid hierarchy of human rankings.” It certainly has been a bit of a whiplash reading experience, through some of the great things and horrible things of our world and the human condition.

I think it is really important I recognize Black History Month, and share with you how very educational and very moving it’s been to read the latter two books at this time. Two of the American presidents covered by Goodwin are Abraham Lincoln, known of course for his leadership in the Civil War, and Lyndon B. Johnson, known for his failures in the Vietnam War and, less so, for his role in pushing through the Civil Rights Act and the Voting Rights Act. Like many famous leaders, he was a complex man.

Wilkerson’s book, Caste, is very compelling, though a tough read throughout. As she points out, Black American scholars have been writing about caste in America since the 1930s, and she builds a brilliant case for the idea that individual and systemic racism are both based on a very deeply embedded ranking of the value of people on the basis of their color. This other line from the cover describes it well: “Beautifully written, original and revealing, Caste: The Origins of Our Discontents is an eye-opening story of people and history, and a re-examination of what lies under the surface of American life today.”

While I highly recommend this book, I reminded myself throughout that Canadians can claim no advantage when it comes to racism, prejudice and bias as shown by what we have done and continue to do to Indigenous and Black people, and other people of colour, in Canada. In only the past week, we have seen a racist incident within our university campus directed at Muslim students during an online meeting, and in a Saskatoon restaurant directed at Asian people working there.

The other book I am reading in installments is One Story, One Song, a collection of short stories by the late Richard Wagamese, an Ojibway man from the Wabaseemoong First Nation in northwestern Ontario. He is probably best known for the novel Indian Horse which was made into a film of the same name. I have heard Val Arnault-Pelletier, CoM Indigenous Coordinator, use the following Richard Wagamese quote many times:

“All that we are is story. From the moment we are born to the time we continue on our spirit journey, we are involved in the creation of the story of our time here. It is what we arrive with. It is all we leave behind. We are not the things we accumulate. We are not the things we deem important. We are story. All of us. What comes to matter then is the creation of the best possible story we can while we’re here; you, me, us, together. When we can do that and we take the time to share those stories with each other, we get bigger inside, we see each other, we recognize our kinship – we change the world, one story at a time…”

So finally, February in Saskatchewan. As a colleague in the Ministry of Advanced Education said yesterday, “Wow, winter has officially flexed its muscles.” There is no better time of the year to curl up with a good book and learn other peoples’ stories. By reading others’ stories and sharing our own, “we change the world.”

Take care! Remember, with the COVID-19 variants now with us, the basics—distance, masks, stay in your bubble, and wash your hands—are more important than ever. And keep warm!

Continuing our commitment to EDI

In this blog, I want to share more information about our plans and next steps for equity, diversity and inclusion (EDI) in the CoM. It’s an incredibly important focus for our college that requires our full commitment and effort now, and always. If we truly want to be the college of our values and principles, and we truly want to achieve our vision and mission, we must make changes to ensure there is real equity of opportunity, diversity across our full team, and respect for one another.

About three years ago, we established our Diversity and Inclusion (D&I) Working Group, composed of 16 individuals including the group’s chair, Chief Operating Officer Greg Power. Given the passage of time, we want to open that group up to others from among our staff, faculty and learners once again, from all corners of our college. In the next few weeks, I will be emailing all students, faculty and staff in the college inviting your interest. Current members of the group can also choose to remain and have been already communicated with in this regard.

This group will be using the soon-to-be-released USask EDI Strategy and Action Plan to develop a strategy specific for the College of Medicine.

Last year, we hired Dr. Erin Prosser-Loose as the college’s senior EDI specialist. She is developing an EDI web page for the college, and beyond, filled with information and resources that will go live in the next few weeks. We will share that new page link with you through E-News and social media as soon as it is live.

Erin is also leading development of a new CoM EDI survey to be issued this spring. It will serve multiple purposes:

  • baseline of where we’re at regarding representation of marginalized members of the college
  • perceptions of an inclusive culture
  • demographic data needed for accreditation

Data collected from this survey will allow our college and the D&I Working Group to focus our initiatives and resources. We will repeat the survey periodically to monitor progress and to ensure our accountability in areas where we are not improving. Findings will be reported college-wide and department-level data will be shared with respective departments, supporting their improvements, as well. Some departments have formed their own EDI committees or have EDI representatives, and the survey data will help inform their activities. Senior leaders of our college will review, discuss and plan improvements, based on the survey data. Significant power to implement change rests with this group.

Of course, I want to emphasize in advance that the survey will be anonymous, with strict methods in place to ensure no individuals can be identified, including setting a reporting requirement of a minimum of five respondents for each potentially identifying category (e.g., racialized people).

These are the next steps our college is taking over the next few months, of an ongoing commitment to EDI. As I’ve mentioned before in my blog and at various meetings, I and our college is committed to being a leader in medical education in this area.

I will continue, through my blog and other venues, to inform you of our ongoing work.

A few other important reminders:

  • If you have not done so already, be certain to complete the Cultural Safety/Competence Survey, which will inform the invaluable work of the Indigenous Health Committee in creating an appropriate and functional Indigenous health structure within the College of Medicine.
  • On February 12, USask On Campus News and our college will share a profile of Dr. Manuela Valle-Castro, director of the Division of Social Accountability, on our websites and social media channels. Manuela brings incredible expertise to our college, the work of that division and our ongoing work in antiracism and EDI.
  • The School of Rehabilitation Science (SRS), which resides within our college as most know, is holding a full accreditation visit March 29 to April 2, 2021. The team in SRS is working hard to prepare for that important milestone. Watch for more news on this and the school in the coming weeks and months.

We continue to work through the challenges of COVID-19 in 2021. I do hope all are staying well and staying safe through these difficult times.

Putting a tough year behind us

With 2020 coming to a close, it’s safe to say most are ready to bid farewell to a year that has been unlike any other. But there are things worth recalling about the two major issues of 2020, as they will inform much of our focus in 2021.

These issues were global and all-consuming stories in 2020. COVID-19 was the first. I’ll start by touching on the second: the increased focus in the news of 2020 on racism. This issue was brought even more to the forefront by pandemic-related injustices experienced by minority groups and those with the least ability to protect themselves from the virus, and the continuing incidences of police violence against Indigenous and Black people here and in the United States. In Canada, the tragedy of the late Joyce Echaquan’s terrible, racist treatment in our own healthcare system must result in change that moves us toward eliminating racism and improving care for Indigenous people in Canada.

I have already stated my commitment and intent that our college will be a leader in medical education in Canada in antiracism and equity, diversity and inclusion. We have made some advances in recent years that I have touched on in previous blogs, and in recent months there have been more focused and intentional conversations about the changes needed between those most affected and our college leaders. But as I’ve said before, we have a lot more to do. Watch for more from me on this in the New Year.

The pandemic has affected all aspects of our work and lives since last March. The response of our college, university and health system in managing the many challenges and necessary changes in how we go about our daily lives was remarkable. It was not perfect, of course, but nothing is. Together, we were on a steep learning curve while rapidly implementing change across large and complex systems. I continue to be particularly impressed by how the people of our university and college came together, and continue working together, to support and protect one another during this frightening and uncertain time.

That said, even as we put 2020 behind us, we cannot put our vigilance and diligence with regard to safety and COVID-19 behind us yet. The numbers in Saskatchewan and across Canada are not good. We can see light at the end of this long tunnel in the form of vaccines that are beginning to reach us now—a remarkable discovery science achievement we also must recall and appreciate about 2020 and the worldwide response to this pandemic. (See this story of the researcher who gambled her life’s work on her belief in the potential of messenger RNA—such an incredible example of why we must fund and commit to discovery research.)

But it will be several months before we reach a true tipping point where we have beaten this virus. So the tenets of 2020 do not change now, nor will they until we are well into 2021, at the earliest. These reminders are taken verbatim from the Saskatchewan Health Authority website:

  • Wear a mask.
  • Wash your hands.
  • Maintain physical distancing.
  • Keep your bubble small.
  • Stay home if sick.
  • Get tested.
  • Follow public health orders.
  • Anticipate situations that put you at risk and avoid them.

Many of us are heading into a two-week break after this week. Let us remember our colleagues on the front lines of care over the holidays and do all in our power to ensure we don’t add to their work. We can do our part by (at a minimum) following all current and upcoming public health measures to stop the spread of COVID-19.

Stay safe and well over this holiday season.

Facing and fighting racism in healthcare and medical education

Today I had the privilege to be part of a national meeting, Urgent Meeting to Address Racism Experienced by Indigenous Peoples in Canada’s Health Care Systems, organized by Indigenous Services Canada. There were nearly 400 participants. This profoundly powerful meeting was precipitated by the videos of the racism during medical care experienced by Joyce Echaquan prior to her death.

What was evident from the moving testimony of the many panelists was that this racism continues every day in every jurisdiction in our healthcare and health education systems. The most compelling testimony was that of the family of Joyce Echaquan. Panelists included many Indigenous physicians, medical students, nurses, and other healthcare professions as well as Indigenous leaders. A significant number of the speakers were from Saskatchewan, including Dr. Veronica McKinney from our faculty, and Perry Bellegarde, National Chief, Assembly of First Nations.

The content of this discussion brought to mind a Harvard-Kennedy School course I just finished, Leadership and Character in Uncertain Times. From that course, one message particularly stands out in the context of today’s meeting: “Mobilizing people with history – acknowledging that people have a historically proven basis for fear and trauma is crucially important to activism. History informs and validates the sense of injustice people feel in the present.”

Many of the accounts today were profound and painful. I have been in healthcare education and care for more than 40 years and sadly I knew they are true. When I first heard the story of Brian Sinclair, I could instantly visualize him sitting in a wheelchair and abandoned in an ER waiting room. When I heard the news of Joyce Echaquan, I did not need to see this video to imagine the racism she experienced while in care. We must improve and we must acknowledge and combat racism at all levels.

The accounts of racism experienced in receiving healthcare in today’s meeting were disturbing and unacceptable. Another area of grave concern for our medical school is racism experienced in medical education. The Indigenous medical students and graduates of our Canadian medical schools describe medical school as a traumatizing experience. Today one Indigenous physician told us she has a daughter in medical school and described seeing her daughter facing the same biases and discrimination she faced.

As part of our role in Justice for Joyce and for Indigenous people here and throughout Canada I am asking every member of our college to commit to anti-racism.

 

 

Staying engaged during a pandemic

The university recently issued a survey to gauge engagement and our community’s thoughts on a variety of questions related to the pandemic and changes in how we are working. Our college was provided with information about how our own staff and faculty responded, and I want to share some details of both with you.

On engagement, across a range of engaged, almost engaged, indifferent and disengaged, we learned that within the CoM, respondents said that 88.4% of them are either engaged (68.5%) or almost engaged (19.9%), compared to all USask respondents at 86.4% either engaged (67.4%) or almost engaged (19%). Those who indicated indifference came in at 7.2%  for the CoM and 7.1% for USask, and those considered disengaged were at 4.5% for the CoM compared to 6.5% for USask.

Generally, especially considering the pandemic, these are encouraging results.

For the USask as a whole, the survey shows respondents have significant pride in their work, and a significant majority (more than 80%) feel they contribute to the success of their department. They like their job and working here, are committed to the organization and are proud of the work USask does across study, research and other areas.

Significant numbers of people (more than 60%) indicated they did not feel ready to return to the workplace. Many also indicated they would like a return that involves more time and flexibility around working from home. Ensuring those working from home have the tools and financial supports in place to support their work was mentioned, as was getting more information and being more proactive about reopening plans, how that will work and what measures will be in place for safety. Some want Zoom access for teaching because they feel it is a superior tool. Others asked for more training in online teaching and using online tools.

The significant takeaways from the survey included that the engagement levels are good, especially in the current context; our people have supported the university in its response to COVID-19 and appreciate the priority USask has placed on health and safety; those on campus generally feel safe at 81%; and there has been good communications frequency regarding the organization’s pandemic response.

People would like more context for decisions and actions; understanding why is important. Many would like more detail on how specific actions and measures will be implemented. For those eager to get back to campus, there is a need to determine acceptable ways to do so, as there is in continuing to allow those who prefer to work remotely to do so.

What does more and more flexible working from home mean in practice for space, students, and faculty and staff? How do we provide more specific, regular and meaningful information regarding impacts of COVID-19 on people’s work? These are some of the questions that have come out of the survey responses, and are being looked at, at university and college levels.

Further work currently underway includes human resource practices relating to remote working policies and processes. For this fall and beyond, there may be further surveys to establish benchmarks and evaluate trends as the school year unfolds and the pandemic continues. I encourage all on our team to respond and share your thoughts through surveys, directly to your supervisors and colleagues, and of course by responding to this blog.

As always, I am happy to hear from you.

A different kind of return

As we return for another academic year in 2020, how we work and learn continues to be impacted by our important efforts to ensure safety and do our part to reduce COVID-19 transmission risks. For many, this year will not be a return to campus in the usual sense. Nonetheless, I do want to welcome everyone back, whether you are learning and working remotely or are present in clinical or other settings around Saskatchewan.

On the medical education side of things, our Undergraduate Medical Education Program team has been working hard to find ways to engage our incoming first-year MD students in our college in various ways. Most recently, this has been planning and executing the online orientation that took place last week. Our whole college welcomes our MD Class of 2024!

Our residents started their new year of training at the beginning of July. The annual resident boot camp for our new first-year residents was handled differently this year, of course, but I have heard wonderful things about how it went in an online format. Kudos to the teams in PGME and ICT for their great work.

The School of Rehabilitation Science welcomes its incoming class in the Master of Physical Therapy program in September, with classes starting September 8. And of course students in graduate studies in our college, across biomedical and health sciences, and population health, continue their path towards completion of their MSc and PhD programs with the fall term starting in September. A Fall Welcome for Graduate Students is planned for September 11 to kick the year off for our graduate students and graduate studies programs.

For our researchers, some have worked with the university and our college for a return to campus guided by processes for safety and physical distancing. Others continue to work remotely. All are being well-supported by our team in the Office of the Vice-Dean Research at the CoM.

Most of our administrative staff continue to work remotely, and based on what we know so far, this will continue for the majority of us into 2021. There is a good possibility that for many who can work remotely, the full academic year for 2020-21 will be managed in this way.

I hope you have found time to enjoy summer and gotten away from work in safe and physically distanced ways, or if not yet, that you have time planned for a break. We still have some great summer weather ahead!

Finally, I want to provide some additional encouragement for everyone as we continue to navigate challenging times. Be sure to access university and college wellness services and personnel for support, if needed. Whether you are among those beginning to return to campus and other work and learning spaces, or if you continue to work remotely, stay safe and be diligent in your physical distancing measures.

A look back

Thinking back to early March of this year is more of a strain on the memory than it should be. So very much has happened in such a short time. It’s hard to believe that only four months ago, we were all heading into our normal places of work and study, visiting stores, restaurants, bars, all kinds of public places, often multiple times daily, without giving it a second thought.

The reality behind these changes remains of primary importance, of course. Many people became critically ill with COVID-19, and globally, the number who have died from it is staggering. The circumstances are grave, indeed. This blog is by no means a suggestion that we are out of the woods, or even on our way out of the woods. That is still some time away, and requires some pretty significant achievements in science, as well as continued changes in human behavior.

In this blog, though, I do want to recap some of the truly significant efforts and transitions that have been made at the CoM. Most of us don’t like change, and we tend to push back when it’s forced on us. So all that has happened in a few short months really is amazing, and in no small part is due to the incredible responsiveness of everyone on our team (and beyond!) in making some big, previously unimagined adjustments in your work, studies and lives. These times we’ve been through together have been tough, but we have pulled together and supported one another, and that’s made it easier than it might have been.

Toward the middle of March, and inside of less than a week, we went from communicating some early changes to campus activities at USask and our college, to sending almost everyone home. Our team planned and supported how we would shift what we could for our learners to remote access. Our Year 3 and 4 clerkship students were barred from clinical learning. While our Year 4 clerks were minimally impacted given the timing, our Year 3 clerks suddenly found themselves removed from almost all their learning. And what they did next was impressive and inspiring. They volunteered in multiple ways to help patients and healthcare workers, to do their part as best they could, outside of clinical medicine. They helped gather PPE, they played a big role in contact tracing, they supported isolated senior citizens, they fundraised for La Loche and other northern communities.

In postgrad, our residents continued to play their important dual role as learners and workers in our health system, in alignment with their level of training. Many volunteered to transition to other areas of care to support the greatest needs. Our learners received amazing assistance and support from our UGME and PGME teams, and many others.

Our medical faculty were also on the frontlines of care, ensuring that they, their teams and facilities were prepared. Researchers stepped away from important projects, many of which were critical to progress in tenure and their career path aspirations. Many members of faculty, and all of our staff suddenly found themselves working from home while trying to stay connected with one another and, remotely, keeping the college moving forward in our mission and our own important roles related to the pandemic.

Beyond all that, our team was part of many other initiatives: our faculty provided public health and medical expertise to support pandemic decision making; education and information was provided to the health system and beyond by our Continuing Medical Education Division; a new program of online support for people with Multiple Sclerosis, Parkinson’s disease and spinal column injuries was offered; Dr. Hassan Masri provided weekly Facebook videos answering COVID-19 frequently asked questions; Dr. Carrie Bourassa was named Indigenous health lead for Canada’s national COVID-19 Immunity Task Force; Dr. Malcolm King assisted with improved mask design for pre-symptomatic COVID-19 patients; and Drs. Joyce Wilson, Kerry Lavender and Cory Neudorf received funding through the CIHR’s rapid response program for COVID-19.

Our research and graduate studies teams worked to support researchers and graduate students through changes and difficulties. We worked together to create an online spring 2020 graduation celebration that we hope filled some of the gap of our usual convocation and banquet celebrations. We found additional virtual ways to support and participate in PRIDE week.

These truly are among the most unusual times most of us have experienced. We have learned important lessons about what we can do when pressed, as well as things we could and should have been doing all along. Our return to a “new normal” needs to be thoughtful and we do need to embrace some permanent change for the better.

As we start a new term, we have gained valuable insights and experience that will guide our continuing efforts to lead improvements in the health and well-being of the people of Saskatchewan and the world.

COVID-19 research successes, and return to research

Exciting news was announced Thursday this week that three of our CoM researchers and their teams have received funding for work on COVID-19 from the Canadian Institutes of Health Research. Congratulations to Dr. Joyce Wilson, Dr. Kerry Lavender and Dr. Cory Neudorf on their successful applications!

Each is leading, respectively, projects that will: investigate the re-purposing of currently approved drugs to treat COVID-19 patients; rapidly evaluate some highly promising therapeutics against COVID-19; and help prepare for future outbreaks by gathering information on the best interventions public health officers have developed across the country. This last project, led by Dr. Neudorf, is also being funded by the Saskatchewan Health Research Foundation.

You can see the full announcement with more information about each project on our website.

Our Office of the Vice-Dean Research (OVDR) at the CoM has provided support to our researchers, with a total of $120,000 in rapid response funds—half from the OVDR and half from the CoM’s Respiratory Research Centre—to catalyze small-scale, time-sensitive research projects focused on contributing to the response to the COVID-19 pandemic. Congratulations to the recipients of this funding, who are listed on the OVDR website.

We are also working closely with the university on steps to bring some research activities and researchers back to campus. There have certainly been a large number of requests from researchers to return. We continue a very robust review process to ensure we consider applications carefully to maintain the safety of all our people accessing campus facilities.

I know many of our researchers are feeling significant urgency to return to campus. In my role on the university’s Pandemic Response and Recovery Team (PRT), I have been part of work to review these requests against provincial requirements; the return-to-research framework has been developed by the university alongside the Saskatchewan Re-Open plan, of course.

Those who can work remotely will continue to do so. The university needs your co-operation in this regard, so that limited resources can be best used to support necessary and critical on-campus research and teaching and learning work.

More information from the university can be found at:

 

What COVID has taught us about public health capacity

Guest blog by Dr. Cory Neudorf

Dr. Neudorf is a professor in the Department of Community Health and Epidemiology at the USask College of Medicine, and a former chief medical health officer for Saskatoon

The first half of 2020 has proven to be one of huge challenge for the health system and society at large. However, it may yet prove to be a year of huge opportunity born out of tragedy and resiliency. As I write this, COVID-19 has stretched health system capacity in many jurisdictions. Interventions to slow the virus have disrupted the economy, while disproportionately impacting the most vulnerable in society and those working in health care and other sectors deemed essential.

Global pandemics have been overcome in the past, but both the scale of COVID’s impact and the response to date have been unprecedented in most peoples’ lifetimes. However, part of the health system was established and specifically trained to do outbreak prevention and management in the wake of pandemics of cholera and influenza in past centuries. The public health system was expanded and entrusted with learning what causes these outbreaks. Public health was funded to train and hire the staff to deal with outbreaks, and given legislative authority to act in the best interests of public safety, well-being and security through broad measures such as quarantine, mass testing, immunization and contact tracing and prevention. In short, public health is here to ensure we are not left vulnerable through delays in decision making in the critical early stages of a pandemic.

Between large outbreaks, these same approaches are used to manage smaller-scale outbreaks and prevent more common communicable diseases, which together improves population health. In the past 100 years, a legacy of improvements  through public health have followed, including routine childhood immunization, workplace safety laws, health inspection of our food, water, air and soil, family planning, and efforts to improve healthy behaviours and the social determinants of health (see History of Public Health – 12 Great Achievements).

One improvement was the creation of pandemic plans at all levels of government, with the mandate to update them continuously as they are tested over time. These reviews resulted in recommendations to invest in stockpiles of personal protective equipment (PPE), ongoing training of staff in the appropriate use of these supplies, and improvements to institutional infection prevention, control processes and infrastructure. As well, strategic improvements have included strengthening public health and primary care systems with adequate surge capacity, and making the pandemic response lead role of the medical health officer clear through legislation.

However, with pressures mounting to cut taxes and shrink budgets, public health and other community investments in prevention may be at risk. Ironically, neglect in funding prevention and the determinants of health can in turn add to the pressures on the acute care system and the need to respond to other health and social downstream effects. Recommendations to re-invest in public health and other evidence-informed upstream health and social programs have been strong and consistent in the wake of smaller crises like water-born outbreaks in Walkerton and North Battleford, SARS (2002/3) and H1N1 (2009/10), and have resulted in small gains in some cases. However, the most recent rounds of budget cuts and re-organization across the country have reversed these gains in many provinces, leaving us vulnerable once again. (See The Weakening of Public Health)

The net effect is Canada has experienced mixed results in our response to the COVID crisis so far. While some residual legacy products of past crises have stood us well, cutbacks and re-organizations have had unintended negative consequences on our ability to be as prepared as we may have hoped in parts of the country. The Public Health Agency of Canada and the Chief Public Health Officer position created in the wake of SARS have certainly helped us respond to COVID nationally. Investments in Saskatchewan in better information systems for communicable disease surveillance and more inspections and immunizations have been helpful.

Thanks to a good initial response to public health measures, the first wave of COVID-19 has been blunted, giving the system time to prepare for a possible second wave or future stressors. Now is the time to prioritize investment in a strong and unified public health system. In the near future, public health must plan for heightened surveillance for signs of setbacks as we gradually loosen early restrictions, and respond with aggressive testing and contact tracing to contain new clusters and outbreaks. Later, a mass immunization program may be needed on the heels of the seasonal flu immunization campaign, with the spectre of a possible second wave of COVID.

Meanwhile, other essential public health services cannot be put on hold indefinitely, as this leaves us vulnerable to other outbreaks caused by low routine immunization levels, an overburdened outbreak control team, or delayed health inspections. Other gains in health promotion and social determinants of health need to continue. Public health and community partners need to also respond to the unintended consequences of the pandemic, including rising overdoses, increases in family violence and homelessness, setbacks in healthy living strategies, and health inequalities.

Now is the time to invest in prevention and surge capacity. We have been given the gift of time. Let’s not waste it.