Canadian Medical Association president says ‘sick’ health care system unprepared for a second pandemic wave

The president of the Canadian Medical Association (CMA) says the country isn’t prepared for a possible second wave of COVID-19 and a shortage of personal protective equipment and poor testing numbers are leaving Canadians vulnerable.

“We’re gambling by reopening,” Dr. Sandy Buchman told the Senate’s social affairs committee Wednesday.

“We need the contact tracing and serological testing in order to make decisions about what to do next … We’re scrambling. In my opinion, we’re not fully prepared for a second wave.”

Buchman issued a dire warning to senators, saying the country’s health care system was “sick” before the pandemic hit and the virus only made things much worse.

He said the system is “breaking down” because of personal protective equipment (PPE) shortages and physician fatigue — and the consequences could be catastrophic if the COVID-19 caseload surges in the fall.

Buchman said there’s an “urgent need” to strengthen the public health system’s capacity to conduct more testing and contact tracing.

He said such measures are the only way to curb the caseload spike likely to follow as many provinces and territories start reopening their economies and relaxing physical distancing measures.

He said the system as it is now has “insufficient information” about the extent of the virus’s spread, since so many people are asymptomatic carriers.

Dr. Theresa Tam, Canada’s chief public health officer, said last month that Canada’s labs have the capacity to test as many as 60,000 samples a day for the novel coronavirus — but we’re still nowhere near that level.

Ontario, for example, ran just 7,382 tests yesterday.

“We cannot consider ourselves civilized if we continue this way,” Buchman said.

‘Significant moral distress’

Buchman said physicians are experiencing a tremendous amount of “anxiety” because, three months into the pandemic, they still don’t have a consistent, reliable, adequate supply of protective equipment for those working on the front lines of this crisis.

“We’d never permit a firefighter to go into a burning building without adequate protection. We can’t expect our front line health care workers to put themselves in harm’s way,” he said.

He said some doctors and nurses are constantly on edge and warns that, without immediate intervention, we can expect “big problems” among health care providers during subsequent waves of the pandemic, such as widespread depression and substance abuse.

“This is causing significant moral distress,” he said.

He acknowledged that the federal government has been working hard to procure PPE for health care workers but said it has failed to be transparent about “what’s in the pipeline.”

He said many doctors are in the dark about PPE shipments and when they might have more masks on hand. He said masks are still being reused often, particularly in rural and remote settings.

Federal Public Services Minister Anita Anand told reporters Tuesday that the government has not taken its “foot off the gas pedal” when it comes to procuring the much-needed equipment.

“We have orders for hundreds of millions of further PPE and other medical supplies,” she said, adding that some 500,000 N95 masks are coming from the manufacturer 3M this month. She said shipments are arriving weekly across the Canada-U.S. border.

Made-in-Canada face shields, components for testing and ventilators are also starting to arrive, she said.

“I want to assure health care professionals that they can have confidence in the PPE coming out of federal warehouses to be distributed by provinces and territories,” Anand said.

‘The virus is still very much alive’

Buchman’s concerns were echoed by Dr. Claire Betker, the president of Canadian Nurses Association, and Dr. Cornelia Wieman, the president of Indigenous Physicians Association of Canada.

Betker told the Senate committee that testing levels are especially worrying and Canada is falling behind other nations in the number of tests pumped through labs on any given day.

“We’re concerned that the virus is still very much alive, still spreading and not well understood,” she said. “Given the lessons of history, we urge an evidence-informed and cautious re-opening.”

Health Canada has been slow to approve serological testing devices; the first such device got the green light on May 12.

For weeks, Canada had no approved way to detect COVID-19 antibodies, which can help contribute to a better understanding of whether people who have been infected are immune to the virus. Access to such testing is limited, even as the Italian-made LIAISON test comes online.

Other jurisdictions, notably the U.S., approved devices sooner, but many experts have concerns about their effectiveness.

CBC