B.C.’s pandemic response was ‘generally effective’ but eroded trust: report

THE CANADIAN PRESS/Chad Hipolito
Provincial health officer Dr. Bonnie Henry speaks during a COVID-19 update at the legislature in Victoria, B.C., on Thursday, March 10, 2022.

A report looking at the B.C. government’s operational response to the COVID-19 pandemic has found it was “generally effective” but that there was an erosion of trust with the public.

Bob de Faye, Dan Perrin, and Chris Trumpy were tasked with looking at the operational response to the pandemic, but decisions made by the provincial health officer, public policy decisions by the B.C. government, and decisions relating to the economic recovery, such as support for small businesses and families were excluded from the review.

READ MORE FROM MARCH 2022: Independent review of B.C.’s pandemic response excludes decisions made by Dr. Bonnie Henry

Though the three were not tasked with making recommendations, the 144-page report made 26 findings on ways that the government could improve the response.

The findings focused on six key areas: public trust of government, preparation, decision-making, communications, implementation, and impacts on Indigenous people.

Public trust of government and communications

As part of the report, a survey where 15,000 people responded was conducted to hear from the public.

One statement respondents were asked to respond to was “I trusted COVID-19 information provided by the government.” Seventy-four per cent of people who responded disagreed, of which 66 per cent strongly disagreed, with the statement.

According to the report, early in the pandemic people had a high level of trust, but over time that level of trust eroded.

“There are many reasons for this…but we are concerned that eroding trust may translate into more resistance to restrictions necessitated by the next province-wide emergency,” the report says.

As time went on in the pandemic, the report finds that communication breakdowns resulted in an erosion of trust. One reason for this is the lack of a communications strategy or clarity of roles for the PHO, ministries, and the government communications officials.

READ MORE FROM JANUARY 2022: ‘People are quite distressed’: COVID communications causing confusion in B.C.

Not adequately communicating that restrictions would change over time also resulted in the public seeing the changes as either incompetence or untrustworthy.

It also found the government did not do a good job of communicating why decisions were made, including why restrictions were introduced or rolled back, and the reasons for treating similar situations differently.

“This is disturbing,” the report says. “The comments we heard were not about understanding what orders do but rather reflect a desire for plain language explanations that would allow people to better understand the reasons for orders— as many put it, ‘the why.'”

While the authors say in the early days of the pandemic there were needs to release less amounts of data due to privacy concerns, the government did not find the right balance in the transparency/privacy trade-off.

“It was necessary and appropriate to ensure that public data disclosure did not violate privacy rights and expectations throughout the pandemic,” the report says. “However, as the risk of breaching privacy declined over time with rising case levels, the level of detailed pandemic data did not seem to be adjusted as quickly as it could have been, given the level of transparency in other jurisdictions.”

Preparation

“In hindsight, it is clear from our work that this success came even though the B.C. government was not prepared for a pandemic,” the report says. “However, B.C. was not alone. Even though experts had been warning for years that it was a matter of when, not if, there would be a pandemic like this one or one caused by influenza, virtually no jurisdiction was fully prepared.”

While the report finds the response was generally effective, there needs to be more done to prepare for future emergencies including improving preparation, improving planning, enhancing the ability to respond, maintain relationships, mitigate supply chain disruption, and recognize social supply chain importance.

Decision-making

The authors found there are ways the province can improve the way it makes decisions in emergency situations, including by responding with suitable approaches, and redefining Emergency Management BC’s role for province-wide emergencies.

It also called for the government to learn from the unintended consequences from policies implemented during the pandemic.

“For example, pandemic pay did not apply to all workers in a particular occupation or delivering a defined service, but rather to workers funded under certain government programs,” the report said. “That caused difficulties for contractors who provided identical front-line services but were either not funded by government or were funded under a program not covered by pandemic pay.”

While decisions made during the pandemic did need to balance trade-offs, the authors noted that the public, public service, and government stakeholders all had low levels of understanding about the public health decision-making considerations.

For data collection, the report says there are key improvements needed, noting there are 37 different IT systems in hospitals and health authorities across the province, many of which are not interoperable with each other.

Implementation

The report found the government needs to improve the public health order rollout, refine the use of public health tools, be prepared to enforce, share goals to collaborate on means, and leverage non-government resources.

Concerns with the public health order rollout included that new or changed health orders were frequently announced then the written order was not made available for days or weeks, the written order often differed from the announcement, it was not always clear if the announcement constituted a legally binding verbal order or notice of a pending written order, and many orders were amended multiple times but how they were amended was not always clear.

For the use of public health tools, the report recommends looking back at all the measures implemented and assessing how successful they were.

Enforcement of the pandemic restrictions, the report says, were often unclear of how and who would be responsible, and some agencies were tasked with enforcement but did not have adequate capacity to take it on.

Indigenous impacts

The report notes that Indigenous people in B.C. faced the same worries, uncertainties and fears as others in the province, but it also triggered historical responses for some.

“As with preparation in general, the B.C. government was not ready for the pandemic in terms of how it would work with Indigenous governments and Indigenous-governed organizations in developing and implementing its pandemic response,” the report said. “Roles and relationships did evolve, and FNHA played an important and effective part in the response.”

During the pandemic, the provincial government was making decisions on behalf of the province, and the report says there also needs to be respect for Indigenous jurisdiction, including the ability to close lands to nonresidents.

There was also a need to address gaps and overlaps in service. The federal government is responsible for funding most of the services provided by Treaty Nations and First Nations governments, which is mostly fulfilled through the FNHA in B.C.

“The pandemic revealed some important gaps that had significant effects on Indigenous Peoples. One was the substantial logistical challenges faced by rural and remote Indigenous communities when physical supply chains for essential goods were disrupted,” the report said. “Another was the effect of the social supply chain disruption, which had the greatest effect on those people most likely to be severely affected by COVID-19.”

Laura BroughamLaura Brougham

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