Page - 44 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE44 Public Health Association noted, was whether these reorganizations “have compromised the core functions of public health.”37 COVID-19 The first Canadian case of COVID-19 was detected on January 25, 2020. Unlike SARS, which was largely confined to a few hospitals, COVID-19 presented more widely, with outbreaks in long-term care homes, meat processing factories, prisons, and Indigenous commu- nities. The mortality rate of COVID-19 is considerable compared to recent pandemics, and, because it is a coronavirus rather than a strain of influenza, the development of a vaccine will be more protracted. Given important differences in transmission, mortality, and treat- ment, the public health actions taken in response to COVID-19 have been more sweeping and restrictive than with previous outbreaks. Although there is interprovincial variation, governments have lim- ited gatherings, closed non-essential businesses, issued directions to health facilities, and declared states of emergency. This required tremendous horizontal coordination across government departments well beyond the health sector.38 As the only country outside of Asia with a significant experience of SARS, Canada had the advantage compared to other western states of being able to use the crisis to develop an institutional protocol for pandemic management. The legal framework following SARS, how- ever, was not itself changed substantially after H1N1. Discussions in the wake of H1N1 did reference the Naylor Report’s recommenda- tions to harmonize legislative frameworks “to permit a determination of the legal status of the measures found to be necessary to meet the public health goal that is in the interests of all Canadians,” including clarification on the use of POGG during pandemics.39 Despite noting the need for greater collaboration, the Senate Report on H1N1 37. Canadian Public Health Association, Public  Health  in  the  Context  of  Health  System  Renewal in Canada (Ottawa: Canadian Public Health Association, 2019), online (pdf): Canadian Public Health Association <https://www.cpha.ca/sites/default/ files/uploads/policy/positionstatements/phhsr-backgrounddocument-e.pdf>. 38. For example, this includes efforts undertaken by Ministries of Justice to move essential court proceedings online and provide law enforcement support for new offences linked to the violation of public health orders, implementing ben- efit plans to support Canadians who are out of work and coordinating with the United States government over the closure of the border, among other actions. 39. Supra note 16 at 24.