Dr. Kendall, what—
Evidence of meeting #58 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was diseases.
A recording is available from Parliament.
Evidence of meeting #58 for Health in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was diseases.
A recording is available from Parliament.
4:45 p.m.
Medical Consultant, Biological, Environmental and Occupational Hazards Directorate, Institut national de santé publique du Québec
I think that we already have a safety net.
4:45 p.m.
Liberal
4:45 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
Answering the same questions?
My concern would be that if it did stay in the act, it would have to be acted on, and then, I would say, there could be unintended consequences that could weaken our existing system.
4:45 p.m.
Conservative
4:45 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
I'm sorry.
If it were left in the act, I would be concerned that it would then need to be acted upon, with the potential downside of the unintended consequences of weakening the public health system and draining away resources to no benefit.
As to whether you might need such a tool, I understood from reading the transcripts of your last meeting around this that the potential exists for a regulatory change immediately if one should discover an epidemiological situation in which a disease, whose characteristics I can't imagine at the moment, did make it necessary or desirable that we stop someone or have advance notice of their carrying the disease from a particular place in the United States to a particular destination in Canada. We could implement a way to block them or stop them at the border if such powers didn't exist in the existing public health, though I think they might.
For example, suppose somebody exposed a theatre full of people in Bellingham to smallpox, and we knew about it. If we knew about it in time, American authorities might be able to put a cordon sanitaire around Bellingham, or we might decide that we would stop land transport coming across the border at that time. In the absence of a defined epidemiological event like that, I don't think we need to have the tool in the tool box. I think we have enough tools, or could put additional tools in if we found a situation that merited them.
4:45 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
Are you speaking on behalf of the public health network? Are all your colleagues across Canada--
4:45 p.m.
Conservative
4:45 p.m.
Liberal
Carolyn Bennett Liberal St. Paul's, ON
Does the public health network of Canada have a consensus on this?
4:45 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
I have consulted only with the public health officials in B.C. who have a responsibility in health areas next to or very close to the border and who would be impacted by this.
4:45 p.m.
Conservative
The Chair Conservative Rob Merrifield
If the committee will allow it, I have a quick question.
I'm trying to get a handle on what we're really looking at. With the SARS situation, the federal Quarantine Act was not invoked; it was only the provincial quarantine act. Each province has its own act. I don't really know exactly how powerful or how different each provincial or territorial jurisdiction's quarantine act is.
Nonetheless, we have this piece of federal legislation before us. I'm trying to envision a ground conveyance. Let's say a Greyhound bus is going from Seattle to Vancouver in the middle of a pandemic--and we know, or hear from experts around the world that it's not a matter of if it will happen but when it will happen--and somebody is deathly ill. The Quarantine Act, to me, would be invoked not necessarily to deal with the ill person, but to make sure the disease or whatever it might be is contained within that bus at either a border crossing or a hospital. That's the thing I envision.
My concern with the testimony here is that you have to think of the worst-case scenario. Why would we weaken something, thereby not allowing for the opportunity for us to contain it in that worst situation? The Quarantine Act has never been abused or overused in my mind, even in the worst situation we've had in the country.
I guess that's my position on it. As a chair, I'm neutral, but either one of you might want to answer and convince me otherwise.
4:50 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
Monique, it's up to you.
4:50 p.m.
Medical Consultant, Biological, Environmental and Occupational Hazards Directorate, Institut national de santé publique du Québec
You don't want to go there?
May 30th, 2007 / 4:50 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
I'm willing to go there, but I want you to talk to this.
4:50 p.m.
Medical Consultant, Biological, Environmental and Occupational Hazards Directorate, Institut national de santé publique du Québec
Okay, no problem.
I'm going to talk in French to be very specific.
A flu pandemic clearly involves an infinitely transmissible disease, by definition. A virus that would cause a pandemic would be very virulent and very easy to transmit. Currently, when such cases first appear, we can try to quarantine the people involved and stop the disease from spreading. Nevertheless, sooner or later, it is very likely that despite all our attempts, the disease will keep on spreading.
Let me come back to your example. We are riding on a bus and a passenger is incubating the pandemic flu. He might not yet be extremely ill, but he can be contagious. This is how pandemic flu behaves. Patients may not show clear symptoms and be contagious nonetheless. In such cases, we can do something, of course, but when the disease is highly contagious, it is very difficult.
It was discovered that SARS was not very contagious unless you got very close to a patient. As a matter of fact, if we look at the places where the disease spread the most, we realize that those places had many problems with hygiene, even in hospitals. When we look at the results of the attempts to monitor fever in order to detect SARS, we realize that this procedure was ineffective in airports, trains and buses.
4:50 p.m.
Conservative
The Chair Conservative Rob Merrifield
Okay, fair enough.
I don't know if Dr. Kendall wants very quickly to add to anything in there or not.
4:50 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
I would agree with Dr. Douville, and it is the opinion of the public health network and the folk who are working on our Canadian pandemic influenza plan that the Quarantine Act is not going to keep pandemic influenza out of Canada. In all likelihood, the first cases we actually identify are going to be second-, third-, or fourth-generation cases, and by the time we pick it up, it's going to be spread in our communities.
4:50 p.m.
Conservative
The Chair Conservative Rob Merrifield
So we throw our hands in the air and give up.
I don't have any more questioners, and we don't want it to go very much longer.
Now I see three. That's what I was afraid of.
Let's try this. Pat has asked for a very quick question and then...another very quick question, and then we'll call it.
4:50 p.m.
Conservative
Patricia Davidson Conservative Sarnia—Lambton, ON
Okay, thank you.
Just quickly, Dr. Kendall, this is a question for you.
I'm told there has been a group of about 130 to 140 Japanese students who arrived in Canada, with one individual diagnosed with measles, and apparently that person had the disease when they got here. I think some of the people are in Alberta and some are in British Columbia. Is that correct--a person in hospital in B.C. and some quarantined in Alberta?
So how does this work, then? The provinces are working together, I guess, but is there a federal quarantine implication in this type of instance?
4:55 p.m.
Provincial Health Officer, Public Health, British Columbia Ministry of Health
I don't believe there is. We're consulting with the Public Health Agency of Canada to coordinate communications. The Japanese student who was incubating measles when she arrived with her tour group became clinically ill and was hospitalized, and the diagnosis of measles was made. The 122 people who were in her tour group were isolated in Banff and were checked for their vulnerabilities. I think about 30 of them were shown to be vulnerable and were offered immunization.
The public health officials in both B.C. and Alberta have tried to track down the places where that tour group went with the girl when she was infectious. They are trying to find out those people who would be most at risk and basically give them information about the symptomology of measles. If they were in those places and they haven't had two doses of the MMR vaccine, they're advised to get their second dose of MMR.