Viewing cable 03OTTAWA989, WGSARS: Canadian Federal Public Health Role

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UNCLAS SECTION 01 OF 02 OTTAWA 000989 
 
SIPDIS 
 
STATE FOR OES/PCI, WHA/CAN (RUNNING) 
 
HHS FOR OFFICE OF THE SECRETARY, OFFICE OF 
INTERNATIONAL AFFAIRS (STEIGER) 
 
CDC for epidemiology program office 
 
E.O. 12958: N/A 
TAGS: TBIO AMED CA
SUBJECT: WGSARS: Canadian Federal Public Health Role 
 
Ref. (A) Toronto 00906 
 
 (B) Ottawa 00899 
 (C) Toronto 00886 
 
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Summary 
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¶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. 
 
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Federal Role 
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¶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- 
sc.gc.ca. 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. 
 
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Comment 
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¶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. 
 
Cellucci