Madam Chair and honourable members, thank you for the opportunity of appearing before the committee again. I am grateful for this chance to give you an update of where I perceive we stand in dealing with this issue. I will remind you that I also appeared before the Standing Committee on Natural Resources on October 19. I will repeat the statement that I made there, that the system is coping. That coping is fragile, and the term that I used was “stressed stability”, which I think provides a fairly good summary of how we are managing.
If I can have your indulgence, Madam Chair, I would like to give a brief overview of where we've come from and then look a little bit to the future.
I think we need to recognize in particular two groups of people who we really have impacted by this and who have responded well. The first is our patients. We have been able to offer tests to all those people who need them, but patients have been asked to attend at odd times. They've been asked to change appointments, and I think we need to recognize the stresses we have placed upon them.
Second and most importantly, I think this crisis has been managed through the very hard work and flexibility of the community, in particular of our technologist colleagues. They have changed shifts, they have changed working practices, and they have changed the hours at which they come in, and I think we owe the Canadian Association of Medical Radiation Technologists a vote of thanks for all they have done.
I think we also need to recognize that the generator manufacturers have really gone above and beyond the call of duty in sharing, in accessing alternative sources of molybdenum and of ensuring that there is some cohesion around the way in which generators are supplied.
We also need to recognize the efforts of Health Canada. They have facilitated regulatory approvals. I think of the Australian OPAL reactor molybdenum approval. The guidance document, upon which we have met and discussed on many occasions, has proved very helpful in enabling institutions and departments to change practice in a way that has really helped deal with the crisis. And most importantly, it has been sharing the supply forecasts and sharing the supply actualities with provincial and territorial colleagues and with individual institutions.
I also think we have been fortunate. The supply of molybdenum has been a little better than we had predicted right at the beginning of the shutdown. Lantheus is the Canadian producer. I will remind you that they supply many sites, particularly in Ontario. They have been at about 50% throughout this crisis. Covidien, the other supplier that relies on non-NRU sources of molybdenum, has obviously been able to supply close to 100% of their customers and has been able to share with Lantheus.
I've provided you with some charts on supply. I'll not go into these in detail, but I would be happy to answer questions. This chart provides an overview of national supply from the beginning of the crisis. This is a composite of Lantheus and Covidien supply. Because Lantheus is the primary Canadian supplier, this reflects the real status across the country, although, for example, if we look at the last week on this chart, we have something between 50% and 60% supply. These figures are very dependent upon the sharing arrangements the companies have had.
The second charts that I have provided to you are from Ontario individual institution supplies. They provide the calibration dates. The bold column provides the original generator activity that they got before the NRU shutdown, the amount ordered, the amount delivered, and then the percentage pre-NRU shutdown, and the amount that was delivered as a percentage of that was requested.
I think these data are important. It's a snapshot of one week of supply to individual institutions, and behind that is the second week.
I will reiterate. I think the situation we currently have is one of stressed stability.
There are a number of concerns. The first is reduction in the number of referrals. Last week I made cross-country phone calls to a number of centres looking at their experience in referrals. The message I got is that there has been no year-on-year change in most of the centres. I think the issues in the small urban centres in Ontario, as Dr. O'Brien has mentioned, are a real concern.