Page - 45 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

45Have the Post-SARS Reforms Prepared Us for COVID-19? recommended that this be accomplished through federal/provin- cial/territorial (F/P/T) discussions and memoranda of understanding rather than legislation.40 COVID-19 shows the need for further inter- governmental collaboration in areas such as national standards for testing and tracing and the distribution of medical supplies, perhaps including a future vaccine. But the coordination of institutions and processes between juris- dictions is not simple merely because it is supralegal. While Canada was able to sublimate most regional differences (however temporar- ily) rather than use pandemic planning to political advantage, the structure of health care in Canada is by nature unwieldy and frag- mented. The rapid collection and exchange of critical data is still beset with issues, one of which is simply the comparability of data collected in real time. The existence of key pandemic protocol means that governments, if not working “in lockstep,” are able to coordinate fundamental policies and do not work at cross-purposes (such as bid- ding against each other for equipment or drugs). But pandemics vary considerably, and the details—especially in an uncertain and data- poor environment—can be more difficult to work out. With H1N1, a significant source of confusion for the public was the sequencing of vaccination, which varied across provinces. With COVID-19, conflict- ing messages arose over whether and how far one could travel within one’s province, the acceptable size of social groups, and the use of face masks. These conflicting messages have been amplified through the widespread use of social media. The formal roadmaps for pandemic management focus primar- ily on two sets of actors—federal and provincial/territorial govern- ments—but the effective execution of public health policies often depends on the collaboration of four levels of government (includ- ing regional and municipal) with other jurisdictions (such as First Nation and Inuit) sitting crosswise on several of these concurrently. Pandemics also require government to coordinate with non-govern- mental entities, such as drug and device companies, private busi- nesses such as the transportation and manufacturing sectors, and the unions representing health care workers. Another lesson from both SARS and H1N1 that is easy to under- stand but difficult to operationalize has been the need for decision makers to comprehend the demands of those working on the front 40. Supra note 18 at 45.