Build Back Better: Supercharging Canada’s Post-Pandemic Transition
Introduction
It has been four years since the World Health Organization (WHO) declared the COVID-19 pandemic in March 2020, and a year since the WHO stated that it no longer presents a global health emergency. COVID-19 still poses a public health risk in many developing countries, where it is a leading cause of death and disability, but for the majority of Canadians who managed to avoid “Long-COVID,” it is now part of our historical experience.
Canada’s strategy for dealing with the COVID-19 pandemic evolved dramatically in 2020. Following a period of strategic neglect in which national policy makers underestimated the public security threat posed by SAR-COV-2, the federal government instituted a coordinated pandemic recovery process that restored much needed institutional resilience. Adhering to a process of intergovernmental coordination not only averted an economic catastrophe, but it also helped to accelerate a short-term pandemic recovery that, until 2023, performed comparatively better than most other countries around the world.
The pandemic shock, along with its long-tail effects, revealed that the world is changing in ways that are often hard to anticipate and understand. Another key lesson arising from the pandemic experience is the degree to which global risks are closely interlinked. The complex interaction of today’s global risks increases the probability that Canada will experience another major disruption within our lifetime. Adapting too slowly to today’s fast-changing reality could imperil current and future generations.
The legacy challenge that Canada faces is learning how to best build the next-generation infrastructure that is both resilient to pandemic-scale shocks and which can “supercharge” Canada’s post-pandemic economic transition.
The Pandemic’s Impact and Legacy
Canada’s institutional resilience and social cohesion helped mitigate the disruption caused by the COVID-19 pandemic. Although the pandemic experience was a rare event there are some important lessons that should not be forgotten.
The pandemic experience exposed long-standing vulnerabilities in Canada’s overstretched healthcare system. In the past four years, millions of Canadians were diagnosed with COVID-19 including 58,000 people who died from the respiratory virus1. In 2022, COVID-19 was the third leading cause of death behind heart disease and cancer while the cost of pandemic-related hospitalizations that year alone is estimated at $2.9 billion2. Canada also experienced the world’s second longest duration of primary and secondary school closures (51 weeks)3.
A recent study concluded that Canada’s initial response to the COVID-19 threat was compromised by pre-existing capacity gaps, inadequate knowledge of historic and modern pandemic threats, deficient data collection, and dysfunctional inter-agency coordination4. As bad as it was for the country, socially and economically, the situation could have been much worse. If Canada had the same mortality rates as the United States (which experienced the world’s highest number of COVID-19-related deaths),5 hospitalizations in the first two years of the pandemic could have reached 2 million and fatalities may have been 70,000 higher6.
Nevertheless, Canada managed the public health security threat better than other countries (with a comparable health-care and economic infrastructure) despite not having its own vaccine manufacturing capability and gaining relatively late access to the life-saving technology (provided by the United States in April 20217.) A combination of factors helped to check the respiratory infection rates and mitigate the economic burden of necessary public health interventions. The most notable factors include: 1) COVID-19 immunity acquired from previous COVID-19 infection, 2) The emergence of less virulent COVID-19 strains, 3) Intergovernmental coordination and an efficient vaccine distribution effort, and 4) Exceptionally high rates of social solidarity and public compliance with the two-dose vaccination programs (80.3 %), including the uptake of booster shots. Between early 2021 and mid-2022, COVID-19 caseloads dropped by about 21% and hospitalizations decreased by 37%8.
A comprehensive suite of federal benefit programs helped to augment local health interventions. Within Canada, the federal benefits provided financial relief to employers and individuals, prevented a rise in poverty, and mitigated income inequality9. By late 2022, the epidemiological situation had improved to the point where it was also safe for Canada to relax COVID-19 border entry restrictions, as well as testing, quarantine, and isolation regulations for all in-bound travelers. Canada’s economic rebound was remarkable, returning to pre-pandemic levels within 20 months10.
This was a historic moment for the country. But it was also short-lived.
A Future Neglected
The cause of the SARS-2-Cov respiratory outbreak is disputed but the consensus view among international scientific, medical, and intelligence experts is that it originated in Wuhan, China, and spread rapidly with devastating and long-lasting effects. In Canada, the COVID-19 pandemic experience has revealed some profound governance gaps and institutional weaknesses that require immediate attention if the country is to withstand a pandemic-scale shock in the future.
Canada’s health care institutions and workforce absorbed a disproportionate large share of the impact and have not fully recovered, despite an unprecedented capital infusion. In 2023, Canada spent $344 billion (12.1% of GDP) on health care which is more than other OECD member countries with universal health-care systems. Health care spending has also been inflated by the cost of caring for those with “Long COVID,” or the “post-COVID condition,” could be $50.6 billion in 202311. The social and economic impact of “Long COVID” may not be known for some time. One Canadian survey found that 40% of “Long-COVID” patients missed at least two weeks of work or school in 202312.
The disruptive impact of COVID-19 on access to health care services in Canada has also been profound. Despite the disproportionate share of public spending on healthcare, average physician wait times have increased from 9.3 weeks in 1993, to 27.7 weeks in 2023, a difference of 198%13. Tragically, the number of people who died while waiting for surgery reached 17,032 in 2022-23, a 64% increase in yearly surgical waiting-list deaths in the preceding five years and a 30% increase over the previous year14. Research has also shown that the number of Canadians with a primary doctor (including access to a walk-in medical facility), a critical indicator of prolonged and heathy living, has dropped from 93% in 2016 to 86% in 202415. Clearly, Canada’s universal healthcare system is neither cost-effective nor patient-centered.
Although the timing of the COVID-19 pandemic could not have been predicted, the federal policy community, which had the hindsight of the 2003 SARS outbreak (that infected 400 people and killed 44), should not have been blindsided. Although there is anecdotal evidence suggesting the lessons learned from the 2003 SARS experience informed the initial COVID-19 response in 2020,16 it is also apparent that Canada’s pandemic response was hindered by a lack of strategic planning, foresight, and preparedness17.
Canada’s initial response to the COVID-19 pandemic was delayed and uncoordinated, impaired by misaligned policy priorities, inadequate data infrastructure, and poor intelligence sharing by the Public Health Agency of Canada (PHAC). The PHAC was established in 2004 in response to questions about the capacity of Canada’s public health system to anticipate emerging health threats. Sadly, PHAC not only underestimated the threat posed by SARS-CoV-2 it failed to mobilize a timely public health response18. This was partly due to the fact that the Global Public Health Intelligence Network (GPHIN), established in 1997 in collaboration with the World Health Organization (WHO) as a sentinel to identify deadly health threats occurring anywhere in the world,19 was on budgetary life support20. Even more troubling is the fact that GPHIN remained under resourced despite its role in the detection of the severe acute respiratory syndrome coronavirus (2003) and the H1N1 (2009-2010 Swine Flu) outbreaks21.
PHAC’s early warning failure is not the only federal example of negligent decision-making that resulted in unsatisfactory outcomes. In its effort to contain the spread of COVID-19, the federal government developed a mobile app called ArriveCan that all returning air travelers to Canada had to download starting in November 2020. Multiple oversight bodies that examined ArriveCan’s governance practices have expressed a litany of legal, ethical, and accountability concerns about the digital technology platform22. These examinations revealed serial policy failures by the responsible agencies, the Public Health Agency of Canada (PHAC) and the Canada Border Service Agency (CBSA), that should have been easy for competent managers to identify and rectify. One of the most egregious errors happened in 2020 when 10,000 people were wrongly instructed to quarantine due to a faulty software upgrade. Similar to the Phoenix pay disaster which a Senate report called an “international embarrassment,”24 the ArriveCan scandal points to a larger problem about the federal government’s in-house information technology capacity, cumbersome procurement policies, and ability to deliver value for money.
Canada’s three-year struggle to manage the COVID-19 pandemic illustrates the need for anticipatory planning in a more dangerous and unforgiving world. National policy-makers may not face a public health security threat in the near future, but a reasonable assumption is that the window of opportunity to prepare for the next global crisis is closing.
An Infrastructure Golden Age for the 21st Century?
Strengthening Canada’s civilian infrastructure has been elevated as a policy priority given the unprecedented shift to digital platforms since the onset of the COVID-19 pandemic, the return of zero-sum geopolitical competition, and the steady growth of global threat actors intent on harming Canada’s economic, social, and democratic institutions.
Each year, Canada’s public sector spends more than $60 billion on domestic infrastructure25. Strategic infrastructure investments are a critical enabler of national security, economic growth, as well as social and environmental progress. In that regard, the federal government mandated the Canadian Investment Bank (CIB) to spend $35 billion on large revenue generating projects (public transit, green infrastructure, clean power, broadband, trade and transportation, and Indigenous communities) in the 10-year period until 2027-2826. Much more capital investment will be needed in the not-too-distant future.
One year out of the pandemic, Canada is experiencing the most profound economic challenge in a century. The value of some traditional drivers of economic growth (eg., abundant fossil fuel exports, young and expanding demographic, global supply chain security) could soon be downgraded due to the powerful rise of geopolitical and geoeconomic forces. As an example, the United States has implemented a $1.2 trillion Bipartisan Infrastructure Framework (or the Infrastructure and Investment Jobs Act, 2021), a second landmark piece of legislation called the Inflation Reduction Act (2022), and a third pillar of President Biden’s industrial strategy, the Creating Helpful Incentives to Produce Semiconductors (CHIPS) and Science Act (2022). Together, these policies supplied federal stimulus in the form of incentives, grants, and loans to facilitate critical infrastructure investments and to accelerate the industries of the future (eg., domestic manufacturing chains, transportation, nanotechnology, artificial intelligence, and clean energy)27.
The forward-looking policies that sit at the apex of President Biden’s industrial strategy support two overarching and complementary goals. Domestically, the industrial strategy is designed to close the country’s $2.6 trillion infrastructure gap. Strategically, President Biden’s signature policy initiatives serves to draw American and foreign investment away from Chinese Premier Xi Jinping’s 10-year-old Belt and Road Initiative (BRI), valued at $1 trillion28.
Catch-Up Is Not a Strategy
Now that Canada has successfully transitioned out of the COVID-19 pandemic, national infrastructure spending priorities must accelerate broad-based economic productivity by reducing business costs, expediting technological advancements, as well as attracting investment and retaining global talent.
However, building world-class infrastructure in Canada will not be easy, particularly in a slow-growth environment. Like the United States, Canada’s civilian infrastructure network is aging and in poor condition29. Much of Canada’s infrastructure was constructed in the 1950s and 1960s (known as the “Golden Age”) when capital investments peaked at 6% of GDP30. Notwithstanding Canada’s expansive geography and trade-dependent economy, investment in infrastructure has in recent decades declined from 3% to 1.5% of GDP, well below Canada’s peer competitors in the Organization for Economic Co-operation and Development (OECD)31.
Canada’s infrastructure stock grew to $2.1 trillion in 2020, but the current asset mix will have to evolve in accordance with the country’s dynamic and geographically diverse needs32. Chronic under investments in Canada’s healthcare, transportation, national defense, and other critical areas have eroded the country’s productivity and ability to withstand a massive external shock. The cumulative impact of this deficit and the cost of closing the gap are extraordinary. One infrastructure study commissioned in 2018 estimated that Canada would have to invest an average of 5.4% of its GDP annually for the next 50 years to close this gap33. Likewise, a 2021 assessment concluded that an investment of $150 billion to $1 trillion would be required to address Canada’s infrastructure gap, but that analysis is based on a narrow definition of the country’s strategic asset class34. Over time, this infrastructure gap could incentivize international business investments to migrate to the United States. Should this happen, Canada could fall further behind its peer competitors and become more economically dependent on its largest trade partner35.
Canada’s inadequate infrastructure capacity is a growing concern that demands ambition and imagination. Both capabilities are in short supply. For example, Canada’s federal infrastructure spending has defaulted toward sporadic and “shovel-ready” stimulus projects. This is in stark contrast to many OECD member countries that plan their infrastructure requirements decades in the future with special attention given to their revenue generating potential and alignment with strategic policy priorities. Canada has also been slower than its OCED counterparts in leveraging public-private partnerships (P3) financing models on projects involving significant risk and complexity.
The federal government is playing catch-up without a realistic strategy or a long-range investment plan. And time is running out for Canada to reverse this downward trajectory.
A Full-Spectrum Infrastructure Strategy
Canada’s national security and economic prosperity depend on the federal government’s ability to build and maintain, protect, as well as fund high-value infrastructure investments. The consequence of failing to keep up with needed infrastructure planning could result in previously unforeseen disasters becoming a future reality.
The critical infrastructure stock that Canada builds in the next decade should be guided by a full-spectrum infrastructure strategy. The federal government is currently working on a National Infrastructure Assessment (NIA) with a view to identifying Canada’s infrastructure needs and creating a long-term planning vision, enhancing interoperability among owners and funders, and optimizing project funding36. A key recommendation that emerged from an extensive public engagement exercise on the NIA was to establish an independent infrastructure commission (IIC) that would be mandated to lead the assessment production process and to provide the federal government with expert and evidence-based advice on future challenges and opportunities.
Ideally, the IIC would function like the United Kingdom’s National Infrastructure Commission which uses a 30-year planning horizon and updates the national assessment every five years37 and Infrastructure Australia, which in addition to conducting rigorous analysis, maintains the infrastructure priority list with the aim of channeling funding to projects with the greatest potential impact38. Given the heavy demands on Canada’s infrastructure, it might be advisable that the mandate of the ICC also include global trends and threat analysis. Organizationally, the IIC’s independence should be safeguarded with a governance structure (oversight board, audit and risk assurance committee, executive management team) and be staffed with private and public sector experts responsible for producing analytical products in one of five strategic domains (space, cyber, air, land, and marine).
Five Strategic Domains
Although the core function of the proposed IIC should be the production of a National Infrastructure Assessment (NIA), it must also have the ability to deliver a long-term vision that is informed by the return of great power politics, geoeconomic competition, proliferating cyber threats, extreme weather events, global migration pressures, and global supply chain disruptions. The principal advantage of bringing a strategic foresight perspective in Canada’s long-range infrastructure planning is that it supports the early identification of challenges and opportunities emerging from multiple change drivers that are shaping the future.
Strategic foresight is a structured process that begins with a broad conceptual framework that reflects where the most significant possible change could happen. In addition to a practical time horizon (7-10 years), strategic foresight should include a multi-domain perspective that refines the spatial boundaries of the conceptual framework, allowing participants to situate future surprises with the greatest potential for harm or benefit. In that regard, a five strategic domain framework (space, cyber, air, land, and marine) is best suited to plan the next-generation infrastructure that Canada needs to both assert and protect its national interests.
SPACE: Canada relies on space-based technology for national security (eg., missile detection), to enable a variety of consumer services (eg., cell phones, television, financial transactions), and to perform essential government functions (eg., environmental monitoring, disaster response)39. In the decades since Canada entered the “space age,” the rising powers of China, India, and Russia have developed substantial space capabilities and all the G20 countries have established their own satellite systems. The growing constellation of national and private service providers (eg., SpaceX, Blue Origin, Virgin Galactic) increases both the scope of geopolitical maneuvering and entrepreneurialism, presenting significant implications for the 21st century.
CYBER: Digitalizing government services has been a Canadian policy priority that predates the COVID-19 pandemic which accelerated the adoption of remote working and exposed the vast digital divide between rich and poor countries. The growing demand for personal accessibility (eg., remote communities) and public security (eg., ransomware, online fraud) means that Canada must work with business and local political leaders to establish clear modernization priorities (eg., replacing outdated system, stabilizing systems at risk of failing, overcome institutional barriers). Securing Canada’s digital connectivity (across all domains) will also involve developing the federal government’s offensive cyber capacity.
AIR: Canada’s vast land mass and relatively small population raises the premium on the country’s commercial aviation infrastructure, search and rescue capability, ground-based infrastructure, as well as its aerospace research and engineering capabilities. Canada supports the world’s fifth largest aerospace industry, due to long-standing government-industry partnerships, but will have to work hard to protect that advantage since commercial air and freight traffic is expected to double internationally by 203640. Following Russia’s illegal invasion of Ukraine in 2022, Canada is also facing increasing pressure from the North Atlantic Treaty Organization (NATO) to increase its military spending – two percent of annual GDP – and to modernize the North American Aerospace Defense Command (NORAD) – which will likely include both ground-based and space-based security capabilities.
LAND: Canada’s land-based critical infrastructure consists of a sprawling network (eg., electric grids, pipeline operations, ports facilities, hydroelectric dams, food supplies and emergency medicine stockpiles, and information technology systems) that face a variety of environmental hazards (eg., earthquakes), human-based threats (eg., microbiology lab espionage, electoral interference), and systems failures (eg., dam or bridge collapse). Municipal governments have a disproportionate asset management responsibility since they own about 61.7% of the infrastructure that underlie the country’s economic growth and quality of life41. The economic burden facing cities is compounded by the federal government’s record-setting immigration targets which are not only outpacing GDP growth but are also stressing the country’s health care, education, and affordable housing. A foreboding and long-term challenge for Canada (which already has one of the world’s highest energy per capita consumption rates) is satisfying escalating energy demands with “clean” sources that are abundant (hydro), cost-effective to generate (small modular reactors), and environmentally sustainable.
MARINE: Canada has the world’s largest coastline which means that many of the country’s historic and popular cities could eventually be lost to rising sea-levels. In the absence of “super dikes,” a four-degree Celsius temperature rise would turn Vancouver’s Stanley Park into an island by 21003. Similarly, the Arctic’s receding ice cover could transform international shipping patterns and increase competition for fossil fuels among Arctic nations. Without an effective deterrence capability (integrated air, land, and marine-based military forces), Canada’s territorial waters, and potentially its northern coastline, are vulnerable to foreign encroachment. In 2019, Russia stepped up its plans to extend its Arctic reach with a massive infrastructure program that includes military outposts, port facilities, and an expanded icebreaker fleet43. In a direct challenge to Canadian sovereignty, China also declared its intention of using the Northwest Passage as a navigation shortcut to the Atlantic Ocean.
Today’s world is highly contested and connected but there are legitimate questions about Canada’s commitment to addressing the potential risks and opportunities in the medium and long-range future. The fiscal dilemma facing the current government as it prepares to deliver the 2024 Budget on 16 April is a cooling economy (1% GDP growth annually), and rising debt costs ($52.1 billion in 2024-25)44, leaving less money to spend on much needed critical infrastructure upgrades without raising taxes45.
Fiscal commitments are not the only problem in need of special attention. Under the $185 billion Invest in Canada Plan, the federal government committed to investing $35 billion in large, revenue generating infrastructure projects delivered in partnership with public, private, and institutional investors. But four years into the project, the government had only spent $5.1 billion across 17 different projects. To reach target by 2027-28, the federal government would have to raise disbursements by 62%46.
Looking past the upcoming budget, the Government of Canada must make some historic decisions about its overall spending priorities, internal recruitment and training capabilities, annual disbursements, as well as the mismatch between public and private sector investments. The good news for the country is that some of the essential building blocks required to design a full-spectrum infrastructure strategy are already in place.
Conclusion
The global COVID-19 pandemic experience has put the spotlight on the federal government’s strategic readiness and capacity for “over the horizon” planning. Federal fiscal interventions helped to avert a public health and economic catastrophe, but they did little to address the country’s lackluster productivity. The next few years are going to be critical as the federal government fully transitions out of its emergency response posture and dedicates itself to building the next-generation infrastructure that the country needs to assert and protect its national interest in the 21st century.
Time is running out to develop the full spectrum infrastructure strategy that will fortify the country’s institutional resilience and accelerate its long-term productive capacity. The world is changing unpredictably, and the cost of inaction could be incalculable. Another complicated factor is the fiscal constraints limiting the range of strategic choices available to federal policy makers. It is an unenviable situation.
Federal policy makers can decide whether to act or pass on this historic challenge. But from a legacy perspective, the choice to make is clear.
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