Question Period Note: OAG Audit Reports During the Pandemic

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Since 2021, the Office of the Auditor General (OAG) tabled reports for four COVID-19 performance audits that involved the Public Health Agency of Canada (PHAC): the Audit of Pandemic Preparedness, Surveillance, and Border Control Measures (March 25, 2021); the Audit of Securing Personal Protective Equipment (PPE) and Medical Devices (May 26, 2021); the Audit of Enforcement of Quarantine and COVID-19 Testing Orders (December 9, 2021); and COVID-19 Vaccines (December 6, 2022). PHAC has been actively working on addressing the recommendations from these audits.
Key Messages
• Protecting the health and safety of all Canadians is the Government of Canada’s top priority.
• The Public Health Agency of Canada’s top priority is supporting Canada’s response to the COVID-19 pandemic. The Agency will be taking all lessons learned into account to be prepared for potential future pandemics.
• The Public Health Agency of Canada accepts the recommendations from the four Auditor General reports related to the pandemic that involve the Agency. Work is underway to respond to these recommendations.
• The Public Health Agency of Canada will continue to consider these findings, along with other audits, evaluations, and further lessons learned from the response to COVID-19, to inform future planning and to position Canada well to respond to future global health events.

If pressed on how PHAC has addressed the recommendations from the audits
• The Agency accepts each of the Auditor General’s recommendations and work is currently underway to respond to the recommendations from these four audits.

Audit of Pandemic Preparedness, Surveillance, and Border Control Measures
• In the Audit of Pandemic Preparedness, Surveillance, and Border Control Measures, the Auditor General made seven recommendations for the Agency related to pandemic planning, health surveillance information, early warning of public health threats, and border measures.
• The Agency has begun making progress in addressing recommendations related to health surveillance information and early warning of public health threats.
• Some recommendations will be completed by March 31, 2025, as the Public Health Agency of Canada and its partners resume regular operations.

Audit of Securing PPE and Medical Devices
• The Audit of Securing PPE and Medical Devices resulted in two recommendations for the Public Health Agency of Canada related to assessing needs and managing the National Emergency Strategic Stockpile.
• The Agency has already completed one recommendation, specifically related to documenting and enforcing a contract management protocol and governance structure, and has begun work on the remaining recommendation.

Audit of Enforcement of Quarantine and COVID-19 Testing Orders
• For the Audit of Enforcement of Quarantine and COVID-19 Testing Orders, the Public Health Agency of Canada has developed a corresponding action plan to address the recommendations.
• Action plans slated for completion by the beginning of 2024, involve improving the Agency’s enforcement of emergency orders imposed to limit the spread of COVID-19 and improving the use of information on the outcomes of its referrals for follow-up.

Audit of COVID-19 Vaccines
• For the Audit of COVID-19 Vaccines, the Public Health Agency of Canada has developed action plans in response to the recommendations related to reducing wastage, completing the implementation of VaccineConnect, expediting work on the Pan-Canadian Health Data Strategy, and resolving barriers to sharing vaccine surveillance data.
• The Agency has begun making progress in addressing these recommendations.

If pressed on how PHAC will address standing issues and be better prepared for the next pandemic
• There are and will be many lessons for everyone from this pandemic, in Canada and around the world, which we are learning from in order to adjust our approach and ensure we remain well positioned and prepared to respond to future global health events.
• The Public Health Agency of Canada’s response, its guidance, and its advice have evolved during the pandemic and been informed by the latest available scientific evidence, epidemiology, and expert opinions, which can change as new information becomes available.

The Public Health Agency of Canada (PHAC) plays a leadership role in preparing for and responding to public health emergencies.
Since the onset of the COVID-19 pandemic, PHAC has directed the implementation of border restrictions and border control measures to help prevent travellers from spreading the virus that causes COVID-19 in Canada.
On March 25, 2020, the first series of emergency orders imposing a nationwide mandatory quarantine under the Quarantine Act came into effect.
Since then, there has been a strong focus from the Office of the Auditor General of Canada (OAG) on the Health Portfolio.
Audit of Pandemic Preparedness, Surveillance, and Border Control Measures
On March 25, 2021, the Auditor General of Canada tabled a performance audit of Pandemic Preparedness, Surveillance, and Border Control Measures. Both PHAC and the Canada Border Services Agency were implicated in this audit. The audit objectives were to:
• Determine whether PHAC was prepared to respond to a pandemic to protect the health and safety of Canadians, supported by accurate and timely public health surveillance information;
• Determine whether PHAC and the Canada Border Services Agency implemented border control and quarantine measures to limit the introduction and further spread in Canada of the virus that causes COVID 19.

Taking into consideration the OAG’s recommendations, PHAC’s response, its guidance, and its advice have evolved during the pandemic and have been informed by the latest available scientific evidence, epidemiology, and expert opinions, which can change as new information becomes available. PHAC has been actively working to address the OAG’s recommendations to be better prepared in the future.

Audit of Securing Personal Protective Equipment (PPE) and Medical Device
On May 26, 2021, the OAG tabled their audit on PPE and Medical Devices, which implicated PHAC, Health Canada, and Public Services and Procurement Canada. This audit focused on:
• whether PHAC and Health Canada, before and during the COVID-19 pandemic, helped meet the needs of provincial and territorial governments for selected PPE and medical devices; and
• whether Public Services and Procurement Canada provided adequate procurement support. Selected equipment for this audit included N95 respirators, medical gowns, testing swabs and ventilators. These items were considered to be at risk due to high global demand, limited suppliers, specific technical requirements and limited domestic production.

PHAC recognized that this audit identified areas for improvement to be better prepared for future health events, including for the management of the National Emergency Strategic Stockpile. PHAC is committed to acting on these recommendations to enhance its preparedness for future public health emergencies.
Audit of Enforcement of Quarantine and COVID-19 Testing Orders
Within the same year of the first two audits, the OAG conducted their third PHAC audit, the audit of Enforcement of Quarantine and COVID-19 Testing Orders. This audit, concentrating solely on PHAC, was the follow-up on the Audit of Pandemic Preparedness, Surveillance, and Border Control Measures. This audit focused on:
• Whether PHAC improved its administration of mandatory orders to limit the introduction of the COVID-19 virus and its variants in Canada;
• Whether PHAC implemented and enforced additional border measures introduced in early 2021 (such as COVID-19 testing for travellers entering Canada and quarantine of air travellers at government-authorized hotels pending the results of their on-arrival COVID-19 tests).
PHAC is working on improving its automated tracking and data quality so it can better follow up with travellers who are subject to border measures and is implementing gender-based analysis plus (GBA+) considerations to mitigate any potential adverse impacts of existing and future programs on diverse and vulnerable groups.
Audit of COVID-19 Vaccines
On December 6, 2022, the OAG tabled the Audit of COVID-19 Vaccines. This audit concentrated on PHAC, Health Canada, and Public Services and Procurement Canada. This audit focused on whether:
• Public Services and Procurement Canada provided adequate procurement support to secure COVID-19 vaccines;
• the Public Health Agency of Canada and Health Canada efficiently provided access to COVID-19 vaccines; and
• the Public Health Agency of Canada and Health Canada’s surveillance of COVID-19 vaccines was effective and timely.

Based on their four findings, PHAC will:
• reduce vaccine wastage and continue working with stakeholders to adjust the management of COVID-19 vaccine surpluses;
• complete the implementation of VaccineConnect, the national vaccine management information technology system;
• expedite its work with provinces and territories to complete the Pan-Canadian Health Data Strategy in order to improve access to quality data;
• resolve barriers to sharing vaccine surveillance data and provide access to the Canadian Adverse Events Following Immunization Surveillance System for Health Canada and case-level details, as needed, to the World Health Organisation and vaccine companies in a timely manner.
PHAC will continue to address the action plans and complete them accordingly, taking into consideration the ongoing response to the pandemic.

• Management has accepted the recommendations found in all four Audits.
• A Deputy Head approved Management Response and Action Plan (MRAP) was developed for each Audit, which includes milestones and timelines.
• PHAC has begun making progress toward the completion of actions to respond to the Audit recommendations.
• The status of MRAPs is monitored on an ongoing basis and progress on deliverables and deadlines is reported quarterly to the PHAC Executive and Departmental Audit Committees.