国际治理创新中心-新冠疫情之后：全球流行病和加拿大的生物安全战略（英）-2021.11-22页_307kb

报告摘要

Summary of Reimagining a Canadian National Security Strategy

Core Content

This document, Reimagining a Canadian National Security Strategy, focuses on the urgent need for a comprehensive and forward-looking Canadian biosecurity strategy in the wake of the COVID-19 pandemic. It highlights the deficiencies in Canada's public health infrastructure that were exposed during the crisis and outlines a series of recommendations for improving preparedness and response to future biological threats.

Main Points

1. Context and Purpose

The COVID-19 pandemic has revealed serious gaps in Canada's public health apparatus, including surveillance, risk assessment, testing, contact tracing, and communication systems.
The Centre for International Governance Innovation (CIGI) launched an ambitious project to reimagine Canada's national security strategy, focusing on biosecurity as a critical component.
The project involved interdisciplinary working groups with over 250 experts, and each theme was led by an independent author, with a special report by the project co-directors.

2. Key Deficiencies Exposed by the Pandemic

Surveillance systems: The Global Public Health Intelligence Network (GPHIN) was able to detect the initial outbreak in Wuhan, but its integration into risk assessment was lacking.
Risk assessment: Canada's risk assessment process was inadequate and not designed to evaluate the potential impact of communicable respiratory diseases like SARS-CoV-2.
Testing capacity: Testing was initially limited to symptomatic individuals and did not scale up quickly enough, leading to insufficient data and delayed responses.
Contact tracing: Contact tracing was fragmented across provinces and lacked centralized oversight, making it less effective.
PPE stockpiles: The National Emergency Strategic Stockpile (NESS) system was underprepared and lacked an electronic inventory system, resulting in shortages during the pandemic.
Equity issues: The pandemic disproportionately affected racialized communities, the socio-economically disadvantaged, and the elderly, underscoring the need for equity-focused strategies.

3. Recommendations for a Biosecurity Strategy

Comprehensive scope: The strategy must address all types of biological threats, including unknown viruses, antibiotic-resistant bacteria, and deliberate acts.
Whole-of-government approach: It should integrate public health, intelligence, border security, and other relevant sectors to ensure coordinated action.
Centralized risk assessment: A dedicated risk assessment office within PHAC is recommended to improve early warning and intelligence coordination.
National surveillance system: The federal government should lead the development of a harmonized surveillance system across the country.
Provincial and Indigenous collaboration: The strategy must involve provincial, territorial, and Indigenous partners.
Transparent communication: A transparent system of messaging is needed to ensure the public understands health measures.
Regular testing and simulation: The strategy must be regularly tested through field exercises and simulations to evaluate readiness.
International leadership: Canada must reinvigorate its international role and demonstrate leadership in global health security.

Key Information

The biosecurity strategy should be bold, coherent, and flexible, with strong political will and bureaucratic support.
GPHIN, Canada's global surveillance system, played a key role in detecting the initial outbreak but was not well integrated into risk assessment.
The NESS system was understocked and logistically challenged, contributing to PPE shortages.
Contact tracing was ineffective due to lack of coordination, insufficient personnel, and data-sharing issues.
Equity must be a central concern in the biosecurity strategy, using a social-determinants-of-health lens.
The strategy must be tested regularly to identify weaknesses and improve response mechanisms.

Conclusion

The key lesson from the pandemic is that preparedness and coordinated action are essential for biosecurity. While a biosecurity strategy is not a guarantee of success, it is a necessary and wise investment that can yield long-term benefits. Canada must move from reactive to proactive approaches in order to better protect its citizens and enhance global health security.

References

Bloodworth, M., Breton, A., and Gully, D. (2021). GPHIN Independent Review Panel Report.
Branswell, C. (2021). The Pandemic: A Slow-Motion Influenza?.
Cheng, Y., Li, K., and Yang, G. (2020). Contact Tracing in the First 100 Confirmed Cases of COVID-19 in Taiwan.
Chen, L., and Yu, H. (2020). Early Vigorous Testing and Contact Tracing in China.
Crowe, S. (2020). Testing Shortages in Canada.
Laing, D., and Westervelt, M. (2020). NESS System Overview.
Levy, A. R. (2021). Reimagining a Canadian National Security Strategy.
Office of the Auditor General of Canada (2021a). Public Health Response to the Pandemic.
Office of the Auditor General of Canada (2021b). NESS System Evaluation.
Pan-Canadian Public Health Network (2018). Emergency Management Plans.
Thompson, R. (2020). Modelling of Early Testing and Contact Tracing.
Wark, W. (2021). GPHIN's Role in Global Health Surveillance.
WHO (2019). GPHIN's Surveillance Capabilities.
WHO (2020a). Interim Guidance on Laboratory Testing for COVID-19.
WHO (2020b). Strategic Preparedness and Response Plan.
Yu, H., et al. (2020). Testing Trends in Canada During the Pandemic.

Acknowledgements

The project was supported by the Government of Canada, the Government of Ontario, and Jim Balsillie, the founder of CIGI. The independent review panel of GPHIN provided critical insights into the need for a dedicated risk assessment office. The co-directors of the project, Aaron Shull and Wesley Work, emphasized the importance of collaboration, transparency, and testing in developing an effective biosecurity strategy.