Health Committee on March 7th, 2016

[The Chair, Liberal, Bill Casey]

Okay, Liberals, who's up? Bryan?

Welcome to the committee.

[Bryan May, Liberal, Cambridge, ON]

Thank you, Mr. Chair.

I am hopefully going to play the role of Mr. Oliver quite well and not embarrass myself.

First of all, thank you all for coming and speaking today. I had a number of questions that have been asked and answered, so thank you for that. The presentation was very thorough. There were a couple of things that we went through fairly quickly just to clarify, so I may be asking questions you may have answered already. I want to echo Mr. Webber's comments. I was relieved to hear some of the things today already about the severity and the risk level for Canadians. There is a bit of a sensational component sometimes with the media, and I was pleased to hear what I've heard so far with regard to the level of threat.

That's actually my first question. From PHAC's perspective, you've identified the level of threat to Canadians as very low. I'm just curious. How do you measure threats like this, and is it different each time? Is there a particular standard that's applied? What defines “very low”, versus “low” to “medium”, “high”, and so on?

[Dr. Gregory Taylor]

That's an excellent question.

Whenever one of these events happens, we do a risk assessment, so we look at the organism, look at transmission models, look at the outcomes, look at if there are ways to prevent it, if there is a vaccine. We look at all of those things and do a risk assessment and come up with what the risk is to Canadians. Granted, the definition of “low” versus “very low” is relatively subjective with that one, but in this case we don't have the virus in Canada. The mosquito vector doesn't exist in Canada. The only way they could infect, which we've just learned, is through sexual transmission. That's relatively new. Initially we didn't know that. Initially we didn't know about blood, because that is relatively new as well, so the estimate was that the risk to Canadians in Canada is very low.

Those risk assessments are updated on a ongoing basis, so we're looking at constantly updating. If new information comes in, research results come in, our scientists look at it again and look at our assessment and say, “Do we need to change that? Has the risk changed or not?” This is exactly the same thing we did throughout the Ebola outbreak, which is why we saw different measures for Ebola. When our assessment came it was still low, but we were watching this and acting.

It's an excellent question that gets into the core of what the agency does on an ongoing basis—constantly doing risk assessments and constantly monitoring that.

[Bryan May, Liberal, Cambridge, ON]

Thank you.

Again, I believe you've touched on this, but I wonder if you can go into a bit greater detail on Canada's contribution to the World Health Organization, specifically with this situation.

[Dr. Gregory Taylor]

We've been working directly with WHO. Dr. Theresa Tam, who is the deputy chief public health officer, is in Geneva as we speak discussing what's going to happen from a scientific perspective, so our contributions at this point in time to WHO in particular have been expertise, etc.

We're working closely with PAHO, and as I alluded to earlier, we're planning on assisting CARPHA in the Caribbean as a potential area with some laboratory assistance. That will happen in the next little while.

At this point in time it's typically expertise. Matt may be sending some folks to CARPHA, for example.

[Bryan May, Liberal, Cambridge, ON]

Excellent, thank you.

With regard to the testing that is available, there was mention that there is no screening for blood at this point. My question is twofold. Is there a hope that this is coming or is there development in that area, and is it something we're even seeking right now? Second, what is the sensitivity and the specificity of the tests that we are trying to use right now?

[Dr. Dana Devine]

I'll address that.

We do know that the companies that make the nucleic acid or NAT-based tests that we use for blood donor screening are actively looking at the possibility of developing a Zika test.

The application of that test is going to be of greatest value in countries where there already is Zika virus, because they have a real problem in needing to ensure that their blood supply.... If you're in Brazil, for example, you want to know that your blood is safe if you're going to transfuse it to other people.

For Canada, unless the situation changes dramatically, because we can't transmit the virus here—we're not a country that has endemic virus—doing blood donor screening doesn't make much sense. If we can get that safety factor by just asking people to delay coming in to donate by three weeks, we wouldn't want to stand up all the ongoing expense of a screening test.

[Bryan May, Liberal, Cambridge, ON]

Do I have much more time?

[The Chair, Liberal, Bill Casey]

You have one minute and 31 seconds.

[Bryan May, Liberal, Cambridge, ON]

I'm going to share that time.

Mr. Singh, do you have a...?

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

I just want to take this a step further.

Are we keeping any records, for example, on how many blood donors we suspect of having Zika virus who we have been turning away? Is there a record of how many people were turned away?

[Dr. Dana Devine]

Yes, we do. When we turn donors away, we record that event and why they were turned away, whatever the reason is.

When we first looked at establishing a deferral for Zika risk, we went back to data that we had collected from Canadian blood donors who travel. We had done an extensive survey in 2014, and we used that as the basis to estimate what our loss of blood donors would be for a 21-day deferral. We were estimating that the loss of blood donors would be just about 3%. From the data we've collected up to about 10 days ago, which is the most recent data I've seen, we are deferring at the rate of just under 3% of donors, who we're asking to please come back in another three weeks and to not donate blood that day.

[Bryan May, Liberal, Cambridge, ON]

Quickly, what is the turnaround time on the Zika testing?

[Matthew Gilmour]

With the molecular testing, as soon as we get it in our hands it can be two to three days to have the results. But for the serology, again, it could take weeks. Without getting too technical, you might be testing both acute blood specimens, so those collected soon after someone's illness, versus convalescence, well after their illness has resolved.

If it's the blood testing, it's multiple specimens, with multiple tests—a screening test, a confirmatory test—so it's quite a milieu of approaches that we have to throw at the problem to finally land on a confirmation. If it's the molecular testing, it can come very quickly.

[Bryan May, Liberal, Cambridge, ON]

Thank you, Chair.

[The Chair, Liberal, Bill Casey]

The next round is five minutes for the Conservatives.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair.

I want to get back to the communications, because as I said before, the best treatment is prevention. When I asked the question in the House a couple of weeks ago, the minister basically said that what we're doing is pointing Canadians to a website.

Frankly, March break is coming up. We have three million Canadians who are going to be travelling to the areas where Zika could be occurring, and on March break there could be a few university students going down there. Regarding your comments that one should avoid having sex with women who could get pregnant, there might be some sex happening when Canadian university students go down south.

You mentioned that you do put it out on Twitter. Is there any other social media you put it out on—Facebook, Instagram, anything along those lines—to get the message out to Canadians, especially young Canadians heading down?

[Dr. Gregory Taylor]

We do use Facebook consistently, yes.

[Colin Carrie, Conservative, Oshawa, ON]

Could you get that back to the committee, just to let us know how you're getting that message out?

[Dr. Gregory Taylor]

Absolutely.

[Colin Carrie, Conservative, Oshawa, ON]

Are we able to ask you if you could get a little feedback to see if the message is getting out?

[Dr. Gregory Taylor]

Okay.

[Colin Carrie, Conservative, Oshawa, ON]

Okay, thanks.

I have the same question for the Canadian Blood Services. Do you guys have the opportunity to help disseminate information? I don't know if the information's getting out there, and in the next couple of weeks, there's going to be...I don't know about the numbers, but a lot of Canadians will be heading down south.

[Dr. Dana Devine]

Yes, you can get all of the information you want on our website, which is what our donors use. We push information to blood donors through electronic means to make sure people are aware of this.

The other thing that has helped us immensely is the amount of media attention on the Zika virus. It's allowed Canadian Blood Services to spread the word that we're asking people to please donate before they go down south, or if they have been travelling there to please not come and donate for 21 days after they've returned.

We believe the message has gotten out there reasonably well.

[Colin Carrie, Conservative, Oshawa, ON]

That's great because I know you guys do a lot of work at universities, and anything that we can do to get the word out...because as my colleague, Mr. Davies, was saying, maybe things are rare, but there could significant sequelae if somebody gets the Zika virus.

I wanted to change topic a bit and talk to Dr. Gilmour about the National Microbiology Laboratory. I know that you do great work over there. I remember the work with Dr. Plummer on H1N1 in coming up with the research, and something that we could be so proud of with the H1N1 vaccine, and the work you did on that.

What is the urgency of vaccine research for Zika? Are you integrated with the WHO on that? Are you doing any work on it?