Public Accounts Committee on March 10th, 2009

[Terence Young, Conservative, Oakville, ON]

You have a 24-hour hotline?

[Dr. David Butler-Jones]

Yes.

[Terence Young, Conservative, Oakville, ON]

I didn't know that. That's excellent.

[Dr. David Butler-Jones]

And we have people monitoring the world, like the Internet and other things, 24 hours a day, looking for potential risks.

[Terence Young, Conservative, Oakville, ON]

Please go ahead. It's very interesting.

[Dr. David Butler-Jones]

I'll go back to the train incident last May, where we get a call, we have concern, we have this train, we have people who are sick on the train, they're apparently Asian tourists. We don't know what's going on. The local police and the health department have gotten involved. We get a call from Ontario. We activate our operations centre. We get transport, VIA Rail, other departments of government involved. We have planned out a series of calls of engagement in terms of what do we need to find out, what do we need to know, how are we going to get the test results out to figure out what's going on. We're communicating with the local medical officer, with the provincial medical officer, and with the local on-the-ground emergency workers, trying to figure out what is actually going on, what's the true story, who's actually on site, who was the person who was taken and flown out, what did they actually have. We talk to the doctors at the hospital in terms of what's going on there.

[Terence Young, Conservative, Oakville, ON]

Are you in charge at the time when this is going on?

[Dr. David Butler-Jones]

I wasn't in the operation centre the whole time, but we have a whole team who are there monitoring the situation, communicating, etc.

[Terence Young, Conservative, Oakville, ON]

Twenty-four hours a day.

[Dr. David Butler-Jones]

The whole team isn't there 24 hours a day, but if we need to we can bring them in.

[Terence Young, Conservative, Oakville, ON]

Please go ahead. It's making a picture for me.

[Dr. David Butler-Jones]

Okay. So I'm in the operation centre. We try to figure out who needs to do what, so you do the planning in terms of what information do we need, what do we need to know, how are we going to find it out, what other things need to be done, what are the kinds of things that you need to do: contain it; make sure that the province and us and the local health authority are onside in terms of how we're going to make sure this doesn't get anywhere in the meantime; what provisions are at the hospital where the woman was taken, to make sure they're isolated so that nobody else in the hospital is affected; and then to work through step by step. The diagnostics—

[Terence Young, Conservative, Oakville, ON]

What about warnings? When do you decide to issue a warning to the public?

[Dr. David Butler-Jones]

It really is at the point where there appears to be a risk. You have to know a little bit about what you're talking about, but if there is something that you don't know about, again there is some judgment call to it. In that case the press already knew. It was international news for a short while, but within the space of three or four hours we were able to figure it out and deal with it in a way that recognized that, no, it's not a public health emergency. It's a tragic event, but it's not a public health emergency and people can get on with their lives. If it had been a public health emergency, then that day we'd be out to the public.

[Terence Young, Conservative, Oakville, ON]

You're saying that like it happened before with SARS, you would have been able to catch it early?

[Dr. David Butler-Jones]

It would be much, much more likely, but never say always.

[Terence Young, Conservative, Oakville, ON]

You were involved because the nurses started to get it, the staff in the hospital. That's when it became frightening, right?

[Dr. David Butler-Jones]

No, there was a problem on the train. The train notified authorities that they had a death and that someone with respiratory symptoms was being flown out. That would automatically go to the local hospital, public health, and the province, which called us.

[Terence Young, Conservative, Oakville, ON]

So you think you'd get a far better result now, if the same thing happened now as it did before with SARS?

[Dr. David Butler-Jones]

All the work that we're doing is targeted to do that.

[Terence Young, Conservative, Oakville, ON]

Do you think you would get a far better result?

[Dr. David Butler-Jones]

Oh, yes, I think so. When I look at all the cases we've had, whether it's tularemia, the H5 outbreaks, H2N2, listeria, or this one, the ability of the system to respond effectively in a coordinated way never existed five years ago.

[The Chair, Liberal, Shawn Murphy]

Okay, thank you very much.

I just have a couple of questions, Dr. Butler-Jones, on the recommendations.

Recommendation 5.50 on page 16 reads:

The Public Health Agency of Canada should periodically evaluate its surveillance systems to ensure that they are working as intended, and it should report the results publicly.

In the Auditor General's report, your agency indicated this would be done by March 31 of this year. Do you think it's going to be accomplished?

[Dr. Gregory Taylor]

Perhaps I could speak to that.

As I mentioned earlier, when we put this together, the evaluations of the systems were being done en totale. In the past, the evaluations have been done independently. So what's happened at the agency is that we've created an entire framework for evaluation of all the systems, a framework that is in place now, and we're going to be doing a number of the individual evaluations over the next few months of the evaluation. So it's coming into place now. It's been a little bit delayed on the planning, because it was done for all of them at the same time and not independently.

[The Chair, Liberal, Shawn Murphy]

But your response was made in May, when you indicated this would be done and the public would be informed. So is there going to be a delay on that, is that it?