The ongoing response to the COVID-19 crisis has shown unprecedented cooperation and collaboration between different orders of government (including health, finance, public safety and emergency management), the private sector, and the voluntary sector. The collaboration we are seeing is effectively a ‘whole-of-society’ response not envisaged since the Second World War or even the Cold War. When this crisis has stabilized, a detailed re-examination of our assumptions, systems, and supporting structures should be conducted to capture lessons learned and formalize the good work done in response to COVID-19.
The end of the Cold War in late 1991 signalled a massive reduction in the threat of nuclear war. Throughout the Cold War, East and West faced the prospect of mutually assured destruction through the exchange of nuclear weapons if things turned ‘hot’. Civilian and industrial centres would be targeted, and Canada as a NATO member would not have been exempt from Soviet action. This was all known at the time, with robust civil defence measures implemented. Though a Civil Defence Coordinator was appointed in 1948, it took until 1959 for an Emergency Measures Organization (EMO) to be formalized at the federal level to protect the population and ensure continuity of government.
The measures taken were extensive. Hardened government communications centres were built across the country to ensure communications in the case of a nuclear attack. The Diefenbunker in Carp, Ontario just outside of Ottawa, is a notable example. This also included stockpiles of material to allow people to carry on and underground hospitals located across the country. The National Emergency Stockpile System (NESS) consisted of 11 central warehouses and over 1300 smaller warehouses across the country. Activation of the NESS and other civil defence measures could have been accompanied with the activation of the War Measures Act. As the Cold War was ending, this was replaced with the Emergencies Act in 1988, showing a perceived thaw in relations with the Soviet Union.
The end of the Cold War and the post 9/11 period changed the threat model upon which the NESS was based. The nuclear war we had previously prepared for seemed less likely. A new range of threats emerged including terrorism, pandemic, natural disasters, and the potential for threats to major events. A 2011 report from the Public Health Agency of Canada  acknowledged these new threats: bio-chemical terrorism, another pandemic like SARS, the need for mass pharmaceuticals for events like the 2010 Olympics, and natural disaster response requiring a different mix of capabilities than originally envisioned by NESS. Unfortunately, there was little action on the report. As we heard recently from the Minister of Health, Patty Hajdu, the NESS has faced under-investment for decades, and has not been a central tool in addressing the COVID-19.
The response we have seen to COVID-19 has been significant and has included all of society. All levels of government are cooperating on response and doing their best in coordinating response measures; the private sector is sustaining supply chain needs and government has removed as many barriers as possible to sustain this; companies are re-tooling manufacturing to meet medical equipment needs, and; government, voluntary and civil society groups are mobilizing to surge support capacity for vulnerable people.
Daily press conferences have kept the public informed on the situations, new risks, and communicated new measures to support people and organizations. In terms of legislation, we have not seen major limitations. The Health Minister invoked the Quarantine Act to enforce self-isolation for Canadians returning from abroad. The Emergency Measures Act has not been implemented, though there has been public debate over whether or not it should be. Some provincial governments have activated their equivalents in order to implement extraordinary measures like closing businesses, public spaces and issuing fines and sanctions to those who do not comply.
Organizations have been collaborating to meet clear needs based on existing best practices. They are utilizing existing response plans and business continuity plans to identify key functions and work through potential challenges to keep people safe and keep society operating. Speed and effectiveness appear to be the key metrics – getting measures in place to protect people and ensuring the sustainability of the supply chain and critical services. Government and public health officials are providing updates as quickly as they can, typically daily, with clarifications provided as required.
There have been challenges, however. A shortage of respirators and safety equipment prompted re-tool and surge manufacturing from some Canadian companies. Personal protective equipment (PPE) shortages are being managed through the global supply chain as best possible. Quebec is seeking hotel space for non-COVID-19 hospital patients to open more capacity in actual hospitals for an anticipated surge in COVID-19 patients and temporary field hospitals construction is being planned. These measures were not part of existing plans. They were the result of the innovation and ingenuity of government and dedication of industry leaders to find immediate solutions.
When the COVID-19 crisis has passed, a detailed review should take place. This is not supposed to be a ‘blame game’ situation, nor should it be. As far as the global response goes, Canada took actions in line
with many other similar countries . The purpose of the lessons learned process is to identify where we can improve threat modelling, long-term planning, improve collaboration, systems and approaches, integrate technology, re-visit legislation if required to build a truly ‘whole-of-society’ approach. We should also identify the implications for all-hazard planning, in addition to pandemic planning. No one is suggesting we rebuild Cold War plans. The threats are different, the context has changed, and technology has changed so much that doing so would be impractical. Nor should we rebuild only for the next COVID-19-type pandemic (although this should be part of the process).
The lessons learned from COVID-19 can form the baseline for the new ‘whole of society’ approach to events, and then be extrapolated for other threats. Future public health crises are likely, in some form or another. However, other threats should also be revisited. Things like infrastructure failures such as the 2003 blackout, weather-based natural hazards like fires, floods, and ice storms, and a range of others should be considered. We need to look at all of the best practices learned from dealing with all hazards that require a whole of society effort.
The COVID-19 crisis and how this has been handled globally will provide an opportunity to ask the tough questions about how we can do better as a society, and which opportunities we take advantage of to limit the impact of future epidemics and other hazards. The costs of prevention are always cheaper than the costs of response. This is an opportunity Canada should not overlook once the crisis has passed.
 Evaluation of the National Emergency Stockpile System (NESS), Public Health Agency of Canada. April 2011
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