House Call with Carol Hughes

Can preparedness become politically desirable?

When historians examine the events that helped shape the COVID-19 pandemic they will have to look at the role that budget cuts and privatization played in Canada’s ability to respond. While market forces were prioritized in the years and decades prior to the pandemic, those efforts to arrive at efficiencies hampered our ability to respond quickly. That’s what happened when we needed to tap the stores of personal protective equipment (PPE) intended for moments just like these and found them depleted. Similarly, our ability to produce vaccines was lost as governments relented to the notion that markets can best provide what is needed and ultimately privatized our last producer.

Canada was not alone in this respect. The idea that we should be prepared for emergencies seems to have slipped from a position of overarching concern for most people and governments once the Iron Curtain collapsed at the end of the Cold War. As the years went by, balanced budgets became more desirable leading to cost-cutting measures that chipped away at preparedness. While we lost the ability to produce vaccines domestically decades ago, the PPE challenges stem from more recent decisions.

That meant that although Canadian companies were involved in the research for vaccine candidates, we would have had to look outside the country to have any viable vaccine produced. Governments had been lulled into a sense of security after Canada lost its last vaccine production company, Connaught Labs. It had been operating at an arm’s length before being fully privatized by the Mulroney government and sold to foreign interests. Subsequent governments weren’t concerned as it was easy to buy vaccines offshore when we were looking for predictable products. It is moments like we are experiencing now that show the benefit of domestic production more clearly.

The problems related to PPE are more recent. Canada had a stockpile, some of which had been allowed to deteriorate while some was shipped abroad when the pandemic began. As recently as the SARS outbreak in 2003, we were better prepared. Budgetary constraints in recent years are the reason that some of our PPE stocks were allowed to expire and hadn’t been replaced. Perhaps worse, the government sent 16 tons of PPE to China when it seemed COVID-19 was confined to that country.

Despite the problems, our PPE deficiency seems to have been easier to pivot on. Within weeks companies were reworking production lines to make the equipment we needed. That said, paramedics were still struggling to find appropriate masks in the summer and there is confusion over which replacements are most effective when the gold-standard N-95 masks are unavailable. Additional concerns relate to production lines that have been established yet remain untapped by government procurement. The solution for vaccine production is not as simple.

New Democrats are calling on the government to get back in the business of making vaccines and other critical medications here in Canada to more quickly protect Canadians now and in future health crises. We believe the best vehicle for this would be a crown corporation. The argument against Connaught Labs was that the business model reflected its academic roots and couldn’t compete. That was a point where public health interests were overridden by market forces. The same can be said for the decisions that left our PPE stocks decimated when we needed them. The notion that the market can address needs has been shown to have its limits. While scientists warn us that pandemic events are likely to increase in our near future, it is unclear if those warnings will be heeded. We are learning there is a cost to everything, that includes costs associated with money not spent on things like domestic vaccine production capabilities and replenishing PPE stocks.