The Canadian Medical Association Journal has issued an urgent call for Canada to strengthen systems of tracking and monitoring diseases, saying Canada is facing a crisis of communicable diseases at the same time the U.S. is dismantling its health institutions.
Canada and other countries have relied on work done in the U.S. to track infectious diseases, address pandemic threats and more. But cuts have drastically reduced the ability of U.S. institutions to do much of that work.
The gutting of public health institutions in the U.S. comes during a period of growing health misinformation and distrust along with the appointment of officials in the U.S. “who seed misinformation”, wrote authors Dr. Shannan Charlebois, medical editor of CMAJ, and Dr. Jasmine Pawa of the Dalla Lana School of Public Health at the University of Toronto.
“A crisis of communicable diseases is unfolding in North America, just as Canada’s health systems’ responses are being hampered by the dismantling of public health and research infrastructure in the United States,” they wrote in an editorial.
The actions “pose immediate and long-term risks to the health of neighbouring countries and to global health,” they wrote.
The growth in distrust and misinformation is also being felt in Canada, especially now.
“People in Canada are vulnerable to a cross-border bleed of not only microorganisms but also of attitudes, health misinformation and exposure to biased U.S. media.”
Canada does not have control of the situation south of the border, but it can strengthen national capacity to manage communicable diseases.
There have long been calls for Canada to strengthen its surveillance systems to better support public health and health care. The need for a more robust system of tracking and understanding health threats is more urgent now, they wrote.
That includes data exchanges between electronic medical records; electronic health records and hospital information systems across the country; and surveillance systems to better understand demographic health trends.
Canada should also do a better job of meeting World Health Organization international health regulations standards by clarifying national rates of vaccination coverage and tracking patterns of antimicrobial resistance.
In Ontario, like much of the country, there is no real-time record of routine vaccination coverage. In order to accurately understand immunization rates, public health officials must do painstaking surveillance that involves tracking students, reminding those whose vaccination records are not up to date and suspending students who do not comply. In Ottawa this spring,
some 3,000 students were suspended
. Even then, public health officials are only able to track a small portion of students at a time.
During a period of rising infectious diseases, having a less-than-clear understanding of vaccination rates can hamper efforts to reduce spread.
Ontario has had more measles cases than in all of the U.S. since February, authors of the editorial noted, and that is not the only communicable disease that has risen sharply. Rates of syphilis and HIV are also spiking in Canada.
Meanwhile, budgets of health institutions in the U.S. have been gutted, while programs to track pandemic threats and mitigate the increasing spread of diseases such as avian influenza and HIV have been decimated. In addition to the human cost, this will affect the reliability of data for long-term estimates of trends and response planning in Canada and the world, in addition to the U.S.
