Canada’s top doctor says there is now community transmission of the Omicron COVID-19 variant in the country and it has the potential to “rapidly escalate” in the days to come.

Chief Public Health Officer Dr. Theresa Tam said Monday she expects the situation playing out in Ontario, where Omicron is responsible for 21 per cent of new cases, to be reflected elsewhere in Canada.

“We’ve learned a lot about this variant just even in the last days. We have learned that it is highly transmissible, or certainly has great spread potential,” she said, stipulating that this may be due to waning community immunity.

“But for sure we are seeing community transmission, possibly in its early stages, but this can rapidly escalate in the days to come.”

The Public Health Agency of Canada said last Friday that should Omicron spread continue at its current rate, Canadians could expect to see 12,000 cases a day by mid-January.

Earlier Monday, Prime Minister Justin Trudeau said the government is “very concerned” with the projections and reinforced the need to get vaccinated.

“Making sure that everyone is double vaccinated is really important as we make boosters available, certain age ranges, please book your appointment,” he said.

The threat of Omicron on an already exhausted health-care system is a message echoed in Tam’s new annual report, A Vision to Transform Canada's Public Health System.

The report warns that Canada’s public health system specifically is stretched “dangerously thin” and action is needed now to ensure the country is prepared for future health crises.

Tam highlights four immediate action areas inspired by the top hurdles that have surfaced over the last two years.

Firstly, as the pandemic has taken a major toll on public health workers, improved recruitment and retaining of staff is necessary to prevent future burnout.

Surge capacity is also required in times of emergency, the report reads.

“The public health workforce is overextended and may not have the capacity to counter the next emergency,” it states.

“Investing in public health workforce capacity requires urgent attention, given the continued burden of COVID-19 on public health practitioners and the ever-present risk of concurrent public health crises.”

Tam is advocating for a workforce that has expertise across a wide range of disciplines, including data science, behavioural science, economics, sociology, and engineering.

She also acknowledges the gaps in Canada’s public health surveillance and data systems, including a lack of data on race and ethnicity and information incongruity between provinces and territories.

To combat this, the report recommends an accelerated implementation of the Pan-Canadian Health Data Strategy with “clear phased milestones.”

“This includes prioritizing systems for interoperable use, such as a national network of vaccine registries that includes socio-demographic data as well as linkages across epidemiological, biomedical, clinical, and health administrative data,” it reads.

Tam also raises the issue of cross-organizational, cross-departmental, and cross-governmental collaboration to understand how public health tools can be better shared.

“It is important that public health governance mechanisms include Indigenous public health expertise and perspectives to enable self-determination, for First Nations, Inuit, and Métis Peoples,” the report reads.

Lastly, without detailing a specific dollar figure, Tam is urging more stable and consistent funding for public health systems.

“Public health resources are often scaled back after public health emergencies as governments move to address other priorities,” the report reads.

“This is referred to as the “boom and bust” cycle of public health spending. This places the public health system at a disadvantage at the onset of each crisis by not having the capacity or the networks required for a rapid response,” the report reads.”

The Canadian Institute for Health Information estimates that public health spending accounts for just under six per cent of total health expenditures in Canada. Meanwhile, hospitals account for 26 per cent of spending and the purchasing of medications account for 15 per cent.

Tam said it’s not just about throwing resources at a problem, it’s about changing the perception of public health so Canadians view it as a priority.

“What I’m trying to do is really stimulate a national shift in our thinking about health. My ambition is to build a future where public health is viewed as central to our daily lives,” she said, during the press conference.

Part of the challenge, Tam added, of gaining long-term investment, is that so much of the work of the Public Health Agency of Canada, if done well, is preventative and not tangible.

“If we don’t go further upstream, as we call it in the report, and prevent people from essentially falling into the river in the first place, and then try to hand people a life jacket at the other end, we will never be able to sustain the kind of investments in our health systems,” she said.

Deputy Chief Public Health Officer Dr. Howard Njoo says upstream spending also requires “political will.”

“If it takes a once in a century pandemic to harness and leverage what I would call political will to make the changes necessary, that’s really at the end of the day what we’re looking at,” he said.

This year’s annual report builds on Tam’s 2020 report From Risk to Resilience: An Equity Approach to COVID-19 which detailed the unequal impacts of COVID-19 on Canadians.