Ontario's Auditor General says the province's response to COVID-19 was hampered by outdated plans, not enough staff, a lack of laboratory surge capacity, and outdated information technology systems.
And Bonnie Lysyk said much of that could have been avoided if Ontario had acted on more of the lessons of the 2003 SARS outbreak.
The Auditor General released her report on the provincial pandemic response on Wednesday morning. Her team looked at emergency management and pandemic response, outbreak planning and decision making, and laboratory testing, case management, and contact tracing.
“...the SARS Commission’s final report identified taking preventative measures to protect the public’s health even in the absence of complete information and scientific certainty as the most important lesson of SARS,” Lysyk said. “Following this principle means taking informed decisive action early. This is not what the audit found; instead, we found systemic issues and delays in decision-making.”
Lysyk's report found that Chief Medical Officer of Health Dr. David Williams and other public health officials did not lead the response to COVID-19. It said Williams did not issue directives to local Medical Officers of Health in order to have a consistent pandemic response, despite a May 2020 document signed by 34 Medical Officers of Health that said more direction and regional consistency was needed. The report also noted it was the provincial government, not Williams, that issued an emergency order in October to mandate mask use.
Laboratory testing, case management, and contact tracing also came under scrutiny in the report. Lysyk said these critical efforts to slow the spread of the virus were not being performed in a quick enough manner to do so.
“For example, between January and August, all but one public health unit could not meet the target of reporting lab test results within a day of specimens being collected 60 per cent of the time. We also found public health units in Toronto, Ottawa, Peel Region and York Region were failing to contact people in a timely manner after testing revealed they were COVID positive between March and August 2020,” she said. “This may have led to further exposure and spreading of the virus.”
Lysysk added that experts pointed out years ago the need for sufficiently funded public health laboratories and improved information systems, but little to no action was taken until the COVID-19 pandemic began. Had those needs been addressed prior, the Ministry of Health could have had better information to "adjust testing eligibility criteria to the highest-risk Ontarians and probable cases, and Ontario could have responded to COVID-19 more quickly, more effectively and more efficiently."
In response to the report, Ontario Health Minister Christine Elliott defended the government's response to the pandemic.
"As a government, we expect to be, and should be, held accountable for our actions and performance, especially in a crisis. However, today’s Auditor General report is in many respects a mischaracterization of the province’s pandemic response," she tweeted. "This pandemic has presented a tremendous challenge to health experts and government decision-makers around the world due to its unprecedented impact and complexity. Thanks to the efforts across government, and with the guidance of our public health experts including our Chief Medical Officer of Health, Ontario has been a leader in our pandemic response, which has always been informed by evidence, assessment of risks and local context. We have benefited greatly from the advice of our public health experts, and we will continue to work with them to confront and defeat the challenges posed by this virus."
The Auditor General's full report can be read here.
