Pandemic early warning system has issued only a handful of alerts since start of 2020

The country's pandemic early warning system has issued only a handful of alerts most of them unrelated to deadly variants of COVID-19 since facing intense public scrutiny and criticism from Canada's auditor general, new federal documents show.

Records obtained by CBC News under access to information reveal thatbetween January 2020 and May 2021,the Global PublicHealth Intelligence Network (GPHIN)delivered only five infectious disease alerts to its nearly 900 subscribers worldwide.

The early warning system had stopped issuing bulletins and was largely silent throughout 2020 just prior toand during the early phases of the COVID-19 pandemic but resumed in the fall of last year following widespread criticism.

It had been muzzled the year before by a series of internal decisions at the Public Health Agency of Canada (PHAC). The agencywanted the surveillance system which scours the internet for signs of infectious disease outbreaks to focus more on domestic health concerns.

Of the five bulletins that were issued, only one of them sent on Nov. 4, 2020 signaled concern about a possible coronavirus variant that reportedly hadappeared on a mink farm in Denmarkand may have made the leap from animals to humans.

The otheralerts involved an outbreak of H5N1 bird flu in Russia, a tick-borne viral infection in China and reports of an unknown disease in the Democratic Republic of Congo.

In contrast, ProMED an internet surveillance program belonging to the International Society for Infectious Diseases (ISID) has issued dozens of alerts over the same period of time. Someof thoseProMEDalerts have beenabout highly transmissible and lethalcoronavirus variants.

It was ProMED, not GPHIN, that first alerted the Canadian military's intelligence branch to the initial outbreak of COVID-19 in December 2019, federal documents show.

"I don't think GPHIN is functioning as is intended to function," said Dr. Ron St. John, a former director general at PHACwho once served as the country's quarantine officer.

Last spring, Auditor General Karen Hogan criticized the federal government's pandemic preparedness and citedthe PHAC changes which silenced GPHIN.

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Karen Hogan says the country's stockpile of emergency equipment should have been better managed.

PHAC "was not as well prepared as it could have been," Hogan reported in her audit mostly because major contingency plans and issues related to surveillance flagged by previous auditors generalhad not been dealt with.

Hogan's audit found that GPHIN did not issue an alert to provide an early warning when COVID-19 first emerged in Wuhan, China. The network did mention the outbreakin a dailyemail report sent to domestic subscribers, including the provinces, with links to related news articles.

Public health officials have defended the absence of an alert, saying that at the end of December 2019, afterother international sources likeProMEDalreadyhad shared news of the virus,it was no longer necessary to issue a bulletin.

The public health agency said it has made changes since the auditor's report was released.

"In recognition of the need for clear decision-making processes, a standard operating procedure was put in place in fall 2020 regarding the issuance of GPHIN alerts," the agency said in a recent statement.

"PHAC is committed to scientific excellence and continuously adapts its processes to enable effective responses to emerging public health issues. Recommendations from the Auditor General and from the GPHIN External Review Panel will be used to inform further developments with respect to GPHIN."

'It's just astounding to me'

In addition to the auditor general's report, federal Health Minister PattyHajdu ordered an independent review of what went wrong with GPHIN. The panel's findings, released in July, noted that the surveillance network was understaffed whenthe pandemic hit andthe system forissuing alerts was lacking.

It's clear the system isstill lacking, said St. John. He saidthe small number ofalerts issuedis a problem,given the threat ofCOVID variants and the fact that governments around the globe and the World Health Organization (WHO) are GPHIN subscribers and rely on the intelligence it provides.

"It's just astounding to me," he said. "If you don't monitor, you won't find infectious disease ... A mutation that becomes more deadly, that's an event that should be detected as soon as possible."

Alerts are still run through senior management at PHAC. The agency said that"if the criteria are met," the director of situational awareness authorizes the bulletin.

Those criteria include "whether the event could represent a chemical, biological, radiological or nuclear incident posing an immediate threat to human health or the environment," the agency said.

St. John said he believes there is still "a lack of understanding of the fundamental principles of what GPHIN was all about, how it operated and what it was intending to do."

GPHINis meant to gatherinformation on emerging health threatsand flagimportant, unusual events to its subscribers,particularlyinternational partnerssuch as the WHO's Epidemic Intelligence from Open Sources (EIOS) initiative. The EIOSsystem collates hundreds of thousands of news articles every day from a broad range of official sites, social media sources and news agencies.

PHACsaidin its statement thatCanada and GPHIN in particular are "key public health partners of the EIOS."

In fact, said PHAC,GPHIN provides "approximately 20 per cent of the total volume of open source data that is fed into the EIOS system."

St. John and others in the public health field say they wonder how the low number of alerts issued by GPHIN, and the handicaps under which it has operated, have affected the assessments EIOS has been producing and the WHO as a whole.