New procurement system stalled restocking of PPE ahead of pandemic: health minister

The Ontario government's switch to a centralized procurement system stalled the replenishment of the province's stockpile of personal protective equipment in the years leading up to the COVID-19 pandemic, an independent commission heard this week.

Health Minister Christine Elliott told the commission examining the crisis's impact on long-term care that the government expected its supply of PPE to be restocked, and that she was not aware at the time that the process had been held up by the change.

The commission has heard that much of Ontario's supply of PPE was destroyed by December 2019 because it had expired.

The panel's co-counsel, John Callaghan, said previous testimony indicated only 10 per cent remained by then, most of which was meant to deal with Ebola rather than a disease like the novel coronavirus.

"You never went to cabinet, you never went to anyone to suggest that the safety of Ontarians would require us to have a stockpile in the face of a pandemic? You never went and made that suggestion?" Callaghan asked the minister.

Elliott replied it wasn't necessary to do so because "there was an expectation that it would be replenished."

"And that is what we were doing, [we are] in the process of doing. But I was not aware that it had been slowed up by the central procurement. I anticipated that it was happening, but I did not know that it had been held up by that."

Commission finds many LTCs lacked PPE early in pandemic

COVID-19 has devastated Ontario's long-term care system, causing the deaths of 3,743 residents and 11 staff members so far. The commission is set to present a report on April 30 that will include recommendations aimed at preventing similar outcomes in the future.

Callaghan pressed the minister on whether the provincial government should bear responsibility if the commission finds Ontario's lack of PPE early in the pandemic led to deaths in the long-term care system. He noted the commission has heard many long-term care homes did not have the required stockpile of PPE when the health crisis began.

"The loss of life here is tragic. And is something that I think everyone in government feels some level of responsibility for," Elliott replied.

"But certainly I knew that there were inspections that were going on in long-term care homes. I would have expected that checking to make sure that they had a supply of PPE would have been something that the inspectors would have checked upon."

Asked whether maintaining an appropriate stockpile of PPE should be legislatively mandated for the province and long-term care homes, Elliott said she didn't believe it necessary, noting homes are already required to do so.

Deputy health minister Helen Angus, who testified alongside Elliott, said it would be helpful to outline the requirements for homes "in more detail going forward," before looking at the mechanism to "compel and enforce it."

Province went against some scientists' recommendations

Elliott also defended the government's decision last summer to give COVID-19 tests to anyone who wanted one, which the commission has heard went against the recommendations of several scientists advising the government, particularly in light of the strained lab capacity and the need to monitor cases in long-term care.

"Looking back, it would have been because of the increase in community transmission and the need to locate where that was coming from and to understand better what was happening in communities," she told the commission.

Callaghan noted scientists have testified they advised the province that would not be an effective strategy. "In fact, you are going to delay the responses from the tests because you are going to have so many of them that are unnecessary," he said.

He also asked why Ontario had not run any pandemic simulations before COVID-19 that likely would have flagged its lack of lab capacity in the face of a surge in testing.

Angus acknowledged the delays in processing tests "at times obviously were unacceptable" but stressed the issue stemmed from the absence of an integrated lab system and that the province quickly moved to fix the problem and ramp up its daily testing capacity.

The commission's hearings aren't open to the public but transcripts are posted online, typically days later.

The minister and deputy minister testified Wednesday and the transcript was released Friday evening.