For seven years, Felix Li served on the distant front lines of Canadian public health in China. As a doctor based in Beijing, he has linked up with health officials who have allowed him to look under the official rhetoric of a country that has been the source of multiple viral epidemics in recent decades.
When Dr. Li returned to Canada in 2015 and retired from the Public Health Agency of Canada (PHAC) after 23 years, he was not replaced.
But he kept in touch with the Chinese public health system and was keen to help when a new epidemic began to emerge.
So, a few days after Wuhan was locked on January 23, he emailed the PHAC, including chief public health officer Theresa Tam, offering her expertise.
“I offered to go back to Ottawa to work with them on this. I needed to help, to save lives, “said Dr. Li in an interview.
In the email, he described his knowledge of the Chinese system and the contacts he maintains there.
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“I received an email saying,” We will talk about it and let you know. “But I never got an answer after that. “
Instead, PHAC relied heavily on the World Health Organization for information and advice in responding to the rapid spread of the deadly new virus.
But critics have questioned the relationship between WHO and China, whose response has been greeted with effusion by WHO. The health organization has raised little public concern about the reliability of the information provided by Beijing, despite evidence suggesting that Chinese authorities have significantly underestimated the death toll from the epidemic.
Dr. Li said that during his stay in China, there was a difference in “the quality of the information” that he was able to obtain by communicating directly with people from the Chinese Ministry of Health and the China Center for Control and disease prevention. During the 2013 H7N9 avian flu epidemic, for example, he received updates directly from Chinese authorities.
If he worked now, he “would probably get a lot more timely and accurate information about things,” he said.
There are good reasons to seek more sources of information, say public health experts.
“In any acute emergency, it is always advantageous to have expertise and contacts” in the field “to access the data and understand the nuances of the real context. It is also always helpful to have multiple sources of data, information or intelligence, and it would be wise to have as many sources as possible, “said James Orbinski, director of the Dahdaleh Institute for Global Health Research at York University.
“Relying on a single source of information for critical decision-making leaves you open to all its biases and limitations, and to all sources – even” official “, like the WHO, the Chinese government, the CIA, the government of the United States. , the Government of Canada – has prejudices and limits. “
PHAC says it has full confidence in its methods – and in WHO. “As the COVID-19 situation continues to evolve rapidly around the world, Canada will continue to work closely with its international partners, including WHO and China, as well as with its provincial and territorial counterparts to reduce risks to Canadians and the planet. “Spokesperson Anna Maddison said in an emailed statement.
The agency can count on Canada’s foreign service “to share and gather information on health and public health issues,” said Ms. Maddison.
However, Canadian embassies and consulates in China have worked with small staff after non-essential employees – including provincial officials – have been sent home.
Unlike the United States, Canada does not have a large global public health unit, which makes it dependent on WHO. It’s not a bad thing, said Srinivas Murthy, an infectious disease specialist at the University of British Columbia who worked with WHO.
“WHO is a very reputable and very strong organization with this capacity,” said Dr Murthy. “I don’t think Canada specifically needs a foreign public health agency. “
But there are also risks in relying on an agency that relies on information from China, a country where statistics are often bent to political imperatives. The United States Centers for Disease Control and Prevention has itself been criticized for cutting staff in China by two-thirds before the COVID-19 epidemic.
In Canada, meanwhile, it seems that health leaders are not getting enough advice on the potential weaknesses of Chinese data provided by WHO, said Charles Burton, principal investigator at the Macdonald-Laurier Institute. who worked twice at the Canadian Embassy in Beijing.
The result is that “politically motivated disinformation from China tragically leads to unnecessary Canadian deaths,” he said.
Dr. Li began his public health work in Beijing in 2008 with the belief that “Canada should not respond to epidemics or pandemics when they reach Canada’s coasts. We must work proactively with China. “
He declined to comment on how China and Canada reacted to COVID-19 for fear of damaging his relationship with public health officials whom he still hopes to work alongside.
“As a doctor and a public health doctor, our job is to save lives. If I were called, I would hop on the next plane to Ottawa, “he said.
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