Preparing for resilience - Si Vis Pacem, Para Bellum.

Canada has faced numerous public health challenges but remains inadequately prepared for future crises. For example, despite extensive reports and plans following the 2003 SARS-CoV-1 outbreaks, the country was unprepared for COVID-19 and lessons learned from the pandemic emphasized the need for immediate action to enhance preparedness. In the current era of poly-crisis, Canada must be ready for diverse challenges, including potential conflicts and their impacts on public health and health systems. The conflict in Ukraine highlights the need for extensive medical resources for returnees, which could strain public health and health systems alongside other concurrent threats. Exercise Trillium Cura (ETC) in 2024 simulated Ontario's health system response to a prolonged conventional war, revealing both successes and challenges. Key issues included leadership and resource needs, with recommendations for specific actions like creating a repatriation hub and a trauma registry. ETC emphasized a "whole of society" approach, engaging civil society in planning and highlighting the importance of integrated preparedness. Tabletop exercises like ETC are crucial for building relationships, shared learning, and innovative solutions. They help prepare for complex crises by fostering collaboration and readiness. Regular exercises are recommended to enhance preparedness and resilience, ensuring effective responses to future health emergencies.