Like you, I’ve been side-eying the COVID-19 (coronavirus) maps, watching the virus creep inwards and upwards towards Saskatchewan from the east and west coasts of the United States.
Also like (most of) you, I’m not panicking. I haven’t stockpiled toilet paper. With a houseful of boys, two dogs and cat, I already stockpile Lysol wipes.
However, since the purpose of risk or threat management – even when its overly cautious – is to avoid the risk or threat altogether, I do try to keep myself up-to-date on the latest information on the virus from legitimate scientific and medical sources.
I also figured I should check out Saskatchewan’s pandemic plan.
Perhaps assuming there was one was my first mistake.
First the internet sent me to the federal government’s pandemic page:
That’s odd, I thought. No Saskatchewan (and no Nova Scotia).
Googled a little more, and I find a Government of Saskatchewan news release… from 2009.
“The 2009 Saskatchewan Health Pandemic Influenza Preparedness Plan outlines the roles and responsibilities of federal, provincial and local authorities in a co-ordinated response to the expected resurgence of H1N1 in the province this fall and winter… It will be updated periodically as new information about H1N1 comes to light.” – Saskatchewan Pandemic Influenza Plan for the Health Care System, Sept 2009
And that’s it folks… that’s Saskatchewan’s 2020 pandemic plan: an 11 year-old response to H1N1.
“So what?” I hear you saying. “Same difference.”
In fact, some of the reasons our province’s 2020 response to COVID-19 must be uniquely different than to H1N1 are laid out right in the Saskatchewan government’s own 2009 plan (which is difficult to find online):
“Each pandemic has some different characteristics and health impacts. New strains of influenza vary in rate of spread, the severity of symptoms caused, and the part of the population most severely affected. An appropriate response to influenza outbreaks must be based on past learning and the unique characteristics of the new strain of influenza virus.“
Then there’s the rather significant issue that the world, with its smartphones and social media and notifyNow alerts etc., is an entirely different place in 2020 than it was in 2009.
Yes, even in Saskatchewan.
But this, also from that 2009 plan, is the bigger problem.
“Each Regional Health Authority (RHA) is responsible for:
- Maintaining a regional pandemic plan
- Holding accountable each RHA affiliated facility/location for the completion of local plans
- Ensuring coordination of services with external stakeholders
- Each plan must meet national and provincial requirements, but be adapted for regional and local level specific needs”
- Each Regional Health Authority…” which we don’t have any of anymore.
Did no one consider a pandemic scenario when we amalgamated the health regions?
Nobody on that Premier’s Award For Excellence-winning transition team thought “hmm, what might be one of the province’s biggest healthcare system challenges and how would one large authority deal with it, as opposed to twelve small ones?”
Because of course the response is going to vary by region in Saskatchewan. Have you seen the size of this place?
I mean, if COVID-19 breaks out in Black Lake, just under the border of Saskatchewan and the Northwest Territories, will critical patients be flown to Royal University Hospital Saskatoon, or will healthcare staff be dispatched to fly up there?
For reasons I don’t quite understand, Saskatchewan’s former health regions seem to each still have individual functioning websites, in which the former region is identified as “part” (or some derivative thereof) of the Saskatchewan Health Authority (SHA).
These sites almost all also have a page dedicated to pandemic preparation. Some still make their documented plan available for download.
But it’s troubling.
For example, on the Sunrise Health Region’s website:
“No items… at this time.”
And that link to a “copy of the provincial plan” link takes you to the HealthLine page on the Saskatchewan government website, where, as of writing this, there is no link to or information on COVID-19 or pandemic planning.
The Kelsey Trail Health Region still has a regional pandemic plan on their website. The plan is embedded with a number of broken or dead links to department-specific supporting plans, which presumably wouldn’t be relevant anymore.
Interestingly, and somewhat reassuringly, some of the school divisions I’ve checked have pandemic plans that seem relatively up-to-date, like this one from South East Cornerstone, which has simply struck-through the words “Sun Country Health Region” and replaced them with “Saskatchewan Health Authority”.
As for rural centres, emergency preparedness is all over the map, but I couldn’t find a plan that was updated to reflect the introduction of a provincial health authority.
The Town of Kerrobert, for example, cites a pandemic as an emergency it is “most likely” to experience (alongside other scenarios like chemical spills and tornados), however their website still references the Heartland Health Region as one of their response partners.
Other centres, such as the City of Regina, simply references the SHA as a stakeholder.
So what do we have in place for a provincial pandemic plan in Saskatchewan?
Well, the SHA website has nothing. Seriously. Just a link to the government’s site.
That link to the government’s website takes you to a page dedicated to “2019 Novel Coronavirus (COVID-19)”. Which is great, but there’s no mention whatsoever of a provincial pandemic response plan, like the ones pictured above created by virtually every other province in Canada.
On the Sask govt page* there is some test info, updated for the first time today in eight days, and some downloadable basic information sheets like this one, which appears to have been largely copied and pasted from the World Health Organization’s (WHO) FAQ page.
What’s my point?
First, there’s the fact that the smaller health regions were shut down in 2017, the Saskatchewan Health Authority has been operational for over two years and a provincial pandemic plan wasn’t created as part of that process.
But there’s also the honesty factor, which is directly related to trust. We need to be able to trust that the Saskatchewan government is putting the needs of the public ahead of its own political goals. Trust that the information we’re getting is untainted by Scott Moe’s election plans.
And I can’t get there right now, because what they’re telling us simply isn’t the truth.
According to a March 5th Govt of Saskatchewan news release:
“The Ministry of Health has a pandemic preparedness plan developed to address influenza. Since COVID-19 is a respiratory illness, this plan will be adapted to respond to COVID-19.”
Some fascinating spin, but it’s total bullshit.
The Ministry of Health has an 11-year-old H1N1 response plan, which heavily – almost completely – revolves around non-existent regional health authorities.
And then there’s this, out today from a top U.S. health official, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases:
“The stated mortality for COVID-19 is around 3%, Fauci said, adding that it started off at 2%. If you count all the estimated cases of people who may have it but haven’t been diagnosed yet, the mortality rate is probably closer to 1%, he said, “which means it’s ten times more lethal than the seasonal flu.” The H1N1 “Swine Flu” epidemic in 2009 was even less lethal than regular seasonal flu, Fauci said.”
IOW, Saskatchewan has an old pandemic plan created to respond to H1N1, which was less lethal than the seasonal flu, but has no plan to address a modern-day pandemic than is ten times more lethal than the seasonal flu.
And you know what – FINE. It is what it is.
So just tell the truth! The whole truth… not half-truths, sorta-truths, maybe-someday-truths.
Which this not, from Minister of Health Jim Reiter in Question Period yesterday in response to a question on the whereabouts of this very plan:
Ohhhhhh I see. It’s “tweaked”. For “different types” of emergencies.
You know… all those pandemic emergencies we’ve had since the plan he’s referring to was written in 2009, for the only (totally unrelated) pandemic emergency we’ve had since 2009, and for the twelve health regions that don’t exist anymore because you amalgamated them, Jim.
Then he says it again!
You know the government is freaking out when the best they’ve got for an answer to the Opposition in QP is ‘I know you’re Dwain Lingenfelter but what am I?’
This while Health Minister in waiting, Rural and Remote Health Minister Warren Kaeding, is sarcastically hollering “SO?? WHAT IF?!?” across the floor of the Legislature, mocking Opposition questions on the government’s response to COVID-19.
Why does any of this matter?
A word on risk management.
Communication is really, really important when managing risk. (Don’t just take it from me, take it from FEMA).
I’ve found myself working increasingly in risk management or mitigation planning over the last decade, because communication is often one of the areas where the least emphasis is placed. When one examines precedent, it is clear that lack of emphasis on comms has often resulted in dire consequences.
But… risks are not fun to plan for, because people don’t like to hear about what could go wrong.
They don’t want to talk about things that Will Never Happen Here.
Til they do.
Planning and even executing a risk mitigation strategy is not fearmongering and taking precautions to mitigate public risk should never be panic-inducing, because with proper and effective communication levels everyone will understand that whole point is to avoid the risk (or threat, if you prefer) from becoming reality.
Which means inherent in the planning and delivery of a risk mitigation strategy – AKA a pandemic plan – is being wrong.
When the risk that you’re trying to avoid never happens, or its impact is low, it’s sometimes impossible to connect the proactive steps you took to the risk you were trying to mitigate.
Or put another way, you might never really know what would have happened if you didn’t take the steps you did to prevent or reduce the threat.
Making it real easy for the I Told You So crowd to declare themselves triumphant and that the risk-planners were wrong.
Stupid, but happens all the time.
And god forbid the Sask Party government put themselves in that position right before an election, right?
Now that, my friends, is what is truly wrong.
And right now, in my opinion, until we see something trustworthy on this from the Sask Party government, THAT is the biggest threat Saskatchewan residents are facing today.
*NOTE: Within an hour of posting this blog, new documents went up on the provincial government’s COVID-19 page, including this one entitled Saskatchewan COVID-19 Preparedness Plan – which is, um, a stretch: 13 pages, including a cover page and a blank back page. 4 pages, more or less, of actual planning – laid out in a half a dozen bullet points per page in 30pt font. The rest is a hastily-assembled mess of copied and pasted info from sites like WHO and the Canadian government’s public health sites. Far too little too late.
I’m Tammy Robert. I’m a writer, but pay the bills consulting in political strategy, media and public relations. Feel free to email me anytime at firstname.lastname@example.org.
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