The pandemic has revealed significant problems in the way Canada collects and processes data on everything from case counts to vaccinations, which has hurt the country’s response to COVID-19, according to a new report produced for the government federal.
Canada was unable to track the spread of the virus as effectively as it needed to last year, according to a report prepared by the Pan-Canadian Health Data Strategy Expert Advisory Group to be released on Thursday. The country is now struggling to keep tabs on vaccine effectiveness due to loopholes in the system, including the way different jurisdictions record and share information.
These data gaps, created by a patchwork of health systems that do not always work together and often encode data in different ways, must be filled with a national approach, the report warns.
“There is no doubt that our response to the pandemic has been severely limited as a result,” says a draft copy of the report, which has been reviewed by The Globe and Mail.
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The report was commissioned by Ottawa last year to examine the data issues exposed by COVID-19. The group will develop a list of recommendations to the Public Health Agency of Canada and other government departments on how to correct these weaknesses, said Vivek Goel, who chaired the review.
When the COVID-19 epidemic struck, problems reporting new cases, symptoms and other crucial data became apparent in Canada’s patchwork system. Since provincial and territorial jurisdictions do not necessarily use the same standards for collecting or coding information, sharing critical data at the national level has become difficult.
“At first it was difficult to get a full national picture, even of the base case number,” said Dr Goel, noting that crucial information such as the sites of the outbreaks or the occupations of those who became ill , were not always collected, codified or shared between health jurisdictions. This left policymakers from knowing where and how the hot spots were developing, and where the next crisis might lurk.
” This [information] is something that is collected at the frontline of public health when people do their interviews, or which is collected when someone shows up for a test. But if they’re not collected consistently from every location and then encoded and loaded into the system, we don’t get a good picture, ”said Dr Goel.
“I would say that if we had had some of this information faster, we might have made some decisions. [by the government] being done earlier, ”said Dr. Goel.
The country has improved in handling information as the pandemic progressed, but “Canada had significant enough challenges at the start to even share and download some of this basic data,” he said. -he declares.
These data gaps have grown as the country attempts to mount a rapid vaccination campaign in these same varied jurisdictions. Lacking the capacity to quickly and effectively aggregate data from across the country, Canada struggles to track vaccine efficacy in real time across the population.
“The most important question regarding vaccination in Canada is probably about the effectiveness of vaccines in the real world with the dosing schedules and the approaches that we have taken in Canada, because we are the country that took the dose interval. the longest, ”Dr. Goel says.
“We have reports that have started to come out, but they are published at the provincial level,” he said. “We don’t have a national report and the systems in each province are slightly different. So we end up with slightly different estimates. They will not be comparable.
More detailed immunization data is also difficult to compile, he said. “We need to put together data on the number of people immunized by age group, occupation codes, all kinds of information. For example, people want to know how many teachers have had [the vaccine]. But we don’t have systems that really allow us to easily collect this kind of data, ”said Dr Goel.
It is also difficult to answer questions specific to Canada, such as the effectiveness of the vaccine mix, without properly collecting and analyzing data from across the country, he said. “We have more of this mix and match coming up, so we need to generate real world evidence on how this works,” said Dr Goel.
The findings echo a report by the Auditor General of Canada in March that said the government lacks proper data procedures to accurately track the spread of the virus. Dr Goel said the problems are due to a number of causes, from lack of investment and concerns about privacy breaches to provinces simply wanting to oversee their own systems.
He also noted that various reports and governments have attempted to address these issues in the past, but the issues have never been resolved. After the SARS outbreak in 2003, Ottawa oversaw the creation of a database system known as Panorama, intended to improve infectious disease surveillance and immunization tracking nationwide. However, the project struggled to gain support, encountered many obstacles and was never effective.
“Despite all of these good intentions, we don’t seem to be making the progress that we would like to see,” said Dr. Goel, a professor at the Dalla Lana School of Public Health at the University of Toronto who is leaving to become president of the University of Toronto. Waterloo next month.
The report calls on Ottawa to work with provinces and territories, as well as First Nations, Inuit and Métis organizations, to create a system where health data, including information on epidemics and immunization , can be shared effectively, and governments can act faster. Overcoming privacy concerns is a major challenge, and any such initiative must ensure that personalized information is protected, the report says.
“We need to address the root causes of the problems that hamper our ability to move forward towards a common goal for all Canadians,” the report said. “Simply put, our systems, processes and policies are geared towards an analog world, as we live in the digital age. “
Dr Goel said there are several examples of countries collecting, sharing and processing data better than Canada, while protecting privacy and respecting regional autonomy. Several Scandinavian countries have systems that Canada should seek to emulate, he said, while the British, despite their own data problems, have put in place a more effective surveillance system in England, Scotland, Canada. Wales and Northern Ireland.
“There are models of how we might approach this in Canada, but until we get to the point where we work together on these things, we end up with these kinds of siled approaches across the country,” said Dr Goel.
“These issues have been underscored by Canada’s response to COVID-19,” the report says. The challenges include “the timely collection and use of screening, case and immunization data; assess the impacts of the pandemic on specific populations; sharing of genomic data for variant management; and the persistent challenges of long-term care.
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