WGSARS: Canadian Federal Public Health Role

UNCLAS SECTION 01 OF 02 OTTAWA 000989 SIPDIS STATE FOR OES/PCI, WHA/CAN (RUNNING) HHS FOR OFFICE OF THE SECRETARY, OFFICE OF INTERNATIONAL AFFAIRS (STEIGER) CDC for epidemiology program office E.O. 12958: N/A TAGS: TBIO AMED CA SUBJECT: WGSARS: Canadian Federal Public Health Role Ref. (A) Toronto 00906 (B) Ottawa 00899 (C) Toronto 00886 -------------- Summary -------------- ¶1. In Canada the provincial governments have the primary responsibility for health matters, including managing public health emergencies. The federal authorities nevertheless do play an important coordination role between the provinces, with other countries and the WHO. In addition to that role the federal authority, Health Canada, has specialized laboratory assets as well as public health specialists, available to assist the provinces. End summary. -------------- Federal Role -------------- ¶2. On March 26, the Government of Ontario declared Severe Acute Respiratory Syndrome (SARS) to be a provincial emergency (Ref B). SARS is now a reportable disease under Ontario's Health Protection and Promotion Act. Ontario provincial health authorities have extended restrictive hospital measures to all hospitals in the province (Ref A) and thousands of residents of Toronto have been asked to quarantine themselves at home for 10 days. This response underscores the fact that primary public health monitoring and infectious disease response is managed at the provincial level. ¶3. Under the Canadian constitution, the provinces have primary responsibility for managing health issues, including public health and disease surveillance matters. There is, nevertheless, a significant role for the Canadian federal authorities and the federal government possesses key assets that support the provincial efforts. ¶4. John Rainford, Crisis Communications Chief at Health Canada explained the specific federal role in managing the SARS outbreak. -- Health Canada issues travel advisories on behalf of the federal government with regard to travel to foreign location. Health Canada's travel advisories are available at the Health Canada website: www.hc- sc.gc.ca. They currently advise against travel to Hanoi, China including Hong Kong, Singapore and Taiwan. -- The federal authorities are the focal point for Canadian coordination with the World Health Organization (WHO). For example, when the WHO issued a global alert for cases of atypical pneumonia on March 12, 2003, Health Canada immediately notified all provinces and territories. Health Canada is also the focal point for coordination with other international partners such as the U.S. Centers for Disease Control and Prevention (CDC). Rainford told us that CDC and Health Canada staff are currently serving in exchange position at one another's Emergency Response Centers to help manage the SARS issue. -- Health Canada operates Canada's "National Microbiology Laboratory", a level 4 Bio-containment facility and laboratory located in Winnipeg, Manitoba, where the Canadian search for the SARS infectious agent is being conducted. We understand that this facility is also a member of the CDC network of laboratories and we understand that its staff is in frequent communication with their CDC counterparts. -- Health Canada provides assistance to the provincial health authorities. For example twelve federal epidemiologists have been sent to Toronto assist provincial public health authorities during the current SARS situation. -- The federal government has powers relating to entry- exit controls. After being informed of the SARS situation, the federal government immediately activated protocols to track potentially infected passengers arriving from the epicenters in Vietnam and China. In instances where a returning passenger shows SARS symptoms, the passenger manifests for that person's flights to Canada have been examined and provincial or territorial public health authorities are in touch with the other passengers to determine if any other passengers demonstrate SARS symptoms. Health Canada also began distributing Health Alert Notices to international passengers arriving in or returning directly to Canada from affected areas in Asia, which advised passengers to see a physician if they began to have symptoms related to SARS (Ref A). Also, Health Canada has sent quarantine officers to Pearson (Toronto),Vancouver and Dorval (Montreal) International Airports to support airport staff. -- In a worst-case scenario, the federal government could invoke the Quarantine Act. The following summary is from Health Canada: "The Quarantine Act would authorize Health Canada to detain persons, goods or conveyances on suspicion that the persons, goods and conveyances might introduce a dangerous communicable disease into Canada. The authority permits detention without due process for a period of 48 hours in order to undertake a medical examination of persons, analysis of goods or inspection of conveyances. If detention is required beyond 48 hours, Health Canada must present evidence for a continuation of the detention in a federal court. These powers also apply to persons and conveyances leaving Canada for another country." Health Canada emphasizes that this Act would only be invoked if necessary and that such an action is not being considering at this time. -------------- Comment -------------- ¶5. Health Canada officials are taking the SARS public health situation very seriously, as evidenced by the support they have provided to the provincial authorities and measures taken to screen passengers at airports. Health Canada is collaborating closely and coordinating efforts with their counterparts across Canada, including the Chief Medical Officers of Health in each province and territory. Furthermore, they are confident that, as and when SARS cases are identified, they will be able to meet any additional provincial requests for assistance. Cellucci