Cablegate: Wgsars: Canadian Federal Public Health Role

This record is a partial extract of the original cable. The full text of the original cable is not available.





CDC for epidemiology program office

E.O. 12958: N/A
SUBJECT: WGSARS: Canadian Federal Public Health Role

Ref. (A) Toronto 00906

(B) Ottawa 00899
(C) Toronto 00886


1. In Canada the provincial governments have the
primary responsibility for health matters, including
managing public health emergencies. The federal
authorities nevertheless do play an important
coordination role between the provinces, with other
countries and the WHO. In addition to that role the
federal authority, Health Canada, has specialized
laboratory assets as well as public health specialists,
available to assist the provinces. End summary.

Federal Role

2. On March 26, the Government of Ontario declared
Severe Acute Respiratory Syndrome (SARS) to be a
provincial emergency (Ref B). SARS is now a reportable
disease under Ontario's Health Protection and Promotion
Act. Ontario provincial health authorities have
extended restrictive hospital measures to all hospitals
in the province (Ref A) and thousands of residents of
Toronto have been asked to quarantine themselves at
home for 10 days. This response underscores the fact
that primary public health monitoring and infectious
disease response is managed at the provincial level.

3. Under the Canadian constitution, the provinces have
primary responsibility for managing health issues,
including public health and disease surveillance
matters. There is, nevertheless, a significant role
for the Canadian federal authorities and the federal
government possesses key assets that support the
provincial efforts.

4. John Rainford, Crisis Communications Chief at Health
Canada explained the specific federal role in managing
the SARS outbreak.

-- Health Canada issues travel advisories on behalf of
the federal government with regard to travel to foreign
location. Health Canada's travel advisories are
available at the Health Canada website: www.hc- They currently advise against travel to
Hanoi, China including Hong Kong, Singapore and Taiwan.

-- The federal authorities are the focal point for
Canadian coordination with the World Health
Organization (WHO). For example, when the WHO issued a
global alert for cases of atypical pneumonia on March
12, 2003, Health Canada immediately notified all
provinces and territories. Health Canada is also the
focal point for coordination with other international
partners such as the U.S. Centers for Disease Control
and Prevention (CDC). Rainford told us that CDC and
Health Canada staff are currently serving in exchange
position at one another's Emergency Response Centers to
help manage the SARS issue.

-- Health Canada operates Canada's "National
Microbiology Laboratory", a level 4 Bio-containment
facility and laboratory located in Winnipeg, Manitoba,
where the Canadian search for the SARS infectious agent
is being conducted. We understand that this facility
is also a member of the CDC network of laboratories and
we understand that its staff is in frequent
communication with their CDC counterparts.

-- Health Canada provides assistance to the provincial
health authorities. For example twelve federal
epidemiologists have been sent to Toronto assist
provincial public health authorities during the current
SARS situation.

-- The federal government has powers relating to entry-
exit controls. After being informed of the SARS
situation, the federal government immediately activated
protocols to track potentially infected passengers
arriving from the epicenters in Vietnam and China. In
instances where a returning passenger shows SARS
symptoms, the passenger manifests for that person's
flights to Canada have been examined and provincial or
territorial public health authorities are in touch with
the other passengers to determine if any other
passengers demonstrate SARS symptoms. Health Canada
also began distributing Health Alert Notices to
international passengers arriving in or returning
directly to Canada from affected areas in Asia, which
advised passengers to see a physician if they began to
have symptoms related to SARS (Ref A). Also, Health
Canada has sent quarantine officers to Pearson
(Toronto), Vancouver and Dorval (Montreal)
International Airports to support airport staff.

-- In a worst-case scenario, the federal government
could invoke the Quarantine Act. The following summary
is from Health Canada: "The Quarantine Act would
authorize Health Canada to detain persons, goods or
conveyances on suspicion that the persons, goods and
conveyances might introduce a dangerous communicable
disease into Canada. The authority permits detention
without due process for a period of 48 hours in order
to undertake a medical examination of persons, analysis
of goods or inspection of conveyances. If detention is
required beyond 48 hours, Health Canada must present
evidence for a continuation of the detention in a
federal court. These powers also apply to persons and
conveyances leaving Canada for another country."
Health Canada emphasizes that this Act would only be
invoked if necessary and that such an action is not
being considering at this time.


5. Health Canada officials are taking the SARS public
health situation very seriously, as evidenced by the
support they have provided to the provincial
authorities and measures taken to screen passengers at
airports. Health Canada is collaborating closely and
coordinating efforts with their counterparts across
Canada, including the Chief Medical Officers of Health
in each province and territory. Furthermore, they are
confident that, as and when SARS cases are identified,
they will be able to meet any additional provincial
requests for assistance.


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