Friday April 9, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday April 9, 2021

Canada’s public health data meltdown

For weeks, Canadians have been casting their envious eyes to Israel, where more than half the country has been inoculated against COVID-19. Israel, less than a quarter the size of Canada, has administered nearly twice as many doses of the COVID-19 vaccine.

The Middle Eastern country has some innate advantages: It is small and centralized, and offered top dollar to ensure vaccines from Pfizer and Moderna would come fast, and in large volumes. But geography and money aren’t the reason why Israel is outpacing Canada by 10-to-one.

Israel has the vaccines because it has the data.

In its shrewd deal with Pfizer, Israel offered to turn the country into one giant clinical trial: Providing the vaccine manufacturer unprecedented large-scale visibility as to the vaccine’s efficacy. It’s all made possible because of the country’s state-of-the-art information technology and robust national vaccination database.

The rest of the world is currently benefiting from that incredibly granular information.

Canada could never have struck such a deal. Its health technology is, charitably, a decade out of date. It lacks the ability to adequately track infectious disease outbreaks, efficiently manage vaccine supply chains and storage, quickly administer doses, and monitor immunity and adverse reactions on a national basis.

Even though all the shipments of vaccines arriving in Canada come with scannable barcodes, to make tracking and logistics easier—with some manufacturers even barcoding the vials themselves—no Canadian province can scan them. In many provinces, pharmacies can’t access the provincial vaccine registry. Provinces do not automatically submit reports on COVID-19 cases or vaccines into the federal system, and must submit reports manually. Many crucial reports are still submitted by fax: Where fax has recently been phased out, they have been replaced by emailed PDFs.

Ours is a dumb system of pen-and-paper and Excel spreadsheets, in a world quickly heading towards smart systems of big data analytics, machine learning and blockchain. It’s unclear how Ottawa will be able to issue vaccine passports, even if it wants to.

At the core of the omnishambles is a simple fact that Canada has no national public health information system, but 13 different regional ones. Many of those regional systems have smaller, disconnected, systems within: Like a Russian nesting doll of antiquated technology.

But there’s good news: It doesn’t have to be this way. In some parts of the country, real progress is being made. Small technology start-ups are figuring out cheap, scalable and innovative solutions. In some provinces, progress can be as simple as updating operating systems.

If we are ever going to build efficient, cost-effective, and effective health infrastructure, Ottawa needs to take the lead. We need to abandon the idea that federalism requires us to have each sub-national government run entirely independent, walled-off, health databases.

We need data sharing. We need shared infrastructure. We need a national public health system. (Continued: MacLean’s)