Auditor general flags lack of evidence-based records to back COVID decisions

The Department of Health was unable to provide evidence-based documentation to substantiate 33 Public Health decisions made during the COVID-19 pandemic, Auditor General Paul Martin says in an audit released Thursday.

The audit covered key operational areas that were meant to reduce the spread of COVID-19, including testing, contact tracing, contact management, and infection prevention and control guidance.

Martin said the department "had numerous systems and procedures in place that were designed to reduce the spread of COVID-19," and went "above and beyond to support New Brunswickers."

But he found "areas for improvement should the need arise," according to Volume 2 of his annual report, which includes chapters on pandemic preparedness and responses by the Department of Health, Department of Education and Early Childhood Development and the Department of Justice and Public Safety.

In his first volume on the government's pandemic response, released in September,  Martin found problems with the level of preparedness, the decision-making process, record keeping and communications.

As part of the next volume on the COVID response, his office selected a sample of 33 recommendations from the Office of the Chief Medical Officer of Health and asked the department to provide evidence-based documentation to substantiate the decisions.

"The department was unable to provide requested documentation, acknowledging that they 'did not create a compendium or a repository of all of the scientific articles, papers, publications and analyses it consulted during the pandemic and therefore we cannot provide a fulsome and detailed list of all of the evidence consulted and used when recommendations were being formulated.'"

Martin found a similar problem surrounding the 300 compassionate travel exemption requests received by the chief medical officer of health.

There was a lack of established criteria to ensure consistent application and transparency of decision-making, according to the report, and 36 per cent of the exemption requests tested by his office did not have a documented rationale for the decision.

While the department had established performance metrics, such as testing turnaround times, outcomes were not monitored or reported upon.

In addition, a lack of inventory-monitoring systems contributed to the department being unable to ensure supplies were provided where needed most, said Martin, noting the demand for COVID test kits was high, with more than 17 million tests distributed as of January 2023.

The auditor general made seven recommendations to address these issues. Among them: ensure the development and retention of adequate documentation to substantiate Public Health measures. The target date is listed as "ongoing."

In its response, the Department of Health said it agrees that documentation related to meetings and decisions should be "reinforced to ensure greater transparency on the decision-making process during health emergencies" and will ensure that "enhanced record keeping practices are integrated into its health emergency operations."