Who exactly is in control of Manitoba's pandemic response?
That is, admittedly, a strange question to be asking as we enter our eighth month of battling COVID-19. However, it suddenly seems to be the question on everyone's lips, as the government's pandemic response comes under increasingly severe criticism from opposition parties and also from independent infectious disease experts.
Uncertainty about who, or what, is in control ramped up over the last week.
On Saturday, the day after public health officials put Winnipeg into a code-red pandemic designation, the Free Press published a scathing analysis of the Progressive Conservative government's response to the fall COVID-19 surge.
Dr. Amir Attaran, a University of Ottawa professor of public health, went as far as to say that it was "the most incompetent reaction" from any province in the country.
How we went from arguably the most-envied province in mid-summer to the most incompetent province in just over 100 days remains a bit of a mystery. And since our story appeared, all attempts by Premier Brian Pallister and his government have fallen well short of a satisfactory explanation.
However, a fact uncovered in the aforementioned Free Press report does point us in the general direction of an explanation.
In the Oct. 31 story, reporter Ryan Thorpe confirmed that the province's "incident management structure" used to plot pandemic response measures, had been deactivated at the end of June because of low case counts.
Two days later — as Winnipeg was placed under a new barrage of social and economic restrictions — Pallister issued a news release indicating that something called the "Unified Health Incident Command structure" was being reactivated.
All of this raises a second, equally important question: who or what was making and informing pandemic decisions while the UHIC was shut down?
Requests for a background briefing (where journalists interview senior government officials on the agreement we do not quote them by name) were denied. The provincial Health Department did, however, send a nearly 800-word email that attempted to explain what the UHIC is and why it was deactivated and then reactivated.
Cutting through all of the technical jargon and bureaucratese in the email, the Health Department confirmed some important facts.
First, major decisions on pandemic response are made officially by Health Minister Cameron Friesen. Which is to say, Friesen, cabinet and — most importantly — the premier. Proposals to inform those decisions flow up from technical experts in the public health system through Dr. Brent Roussin, the chief medical officer of health, and Lanette Siragusa, the province's top nurse. And in the first few months of the pandemic, those experts and their ideas were co-ordinated through the Unified Health Incident Command structure referenced in Pallister's news release.
According to the background email, the UHIC has several functions, including planning, operations, public health operations, logistics (including PPE procurement), finance and service delivery.
Were all these functions actually deactivated, as our story revealed and the government's news release strongly suggested? The background email strongly suggested that many of the functions continued to exist, although they were not co-ordinated through a unified structure. And, that the UHIC "transitioned to a focus on planning for the anticipated surge in activity related to respiratory virus (flu) season."
Attempts to gain clarity on this muddled explanation proved fruitless. But taken at face value, the emailed statement suggests that in June, when it appeared that we had dodged the worst of the pandemic, the co-ordinated command structure of the public health system shifted its focus to flu season.
Although there is an important overlap between influenza and COVID-19, Roussin has consistently maintained that both viruses present unique challenges. The bottom line is that someone, at some point, made a decision to deactivate the province's principal pandemic planning and response entity and, to date, no one is willing to say who that was.
Does all that mean we took our eye off the COVID-19 ball? Pallister dismissed those suggestions at his Monday media availability, suggesting that decisions that needed to be made were made as conditions warranted. However, the anecdotal evidence suggesting Manitoba was unprepared for a second wave of COVID-19 cases is pretty overwhelming.
As cases surged in Winnipeg, citizens found intolerably long lines at testing facilities. Some waited all day only to be turned away. We were desperately short of testing sites, staff to do testing and lab capacity to process the samples.
At the same time, the province failed to build up our contact-tracing system, one of the most important responses government can use to contain an outbreak. Manitoba has been forced to admit that it does not have enough trained people to conduct contact tracing in a timely way to help stop people who have been inadvertently infected from unwittingly spreading the virus.
Setting aside all of the vagaries about bureaucratic hierarchies, there is little doubt now that we did not use the summer lull in COVID-19 cases to prepare for another surge. Instead, it appears Manitoba hung up a "Mission Accomplished" sign and shut down the unified entity that focused specifically on COVID-19 to prepare for flu season.
Who ultimately made that decision, and why they made it, is anyone's guess. The story of how we went from first to worst in pandemic response remains, at this stage, a mystery wrapped in the enigma of bureaucratese and starved of political accountability.
Born and raised in and around Toronto, Dan Lett came to Winnipeg in 1986, less than a year out of journalism school with a lifelong dream to be a newspaper reporter.