Health Committee on May 30th, 2007

[Dr. Monique Douville-Fradet]

That's part of the point I wanted to make.

It's not a full guarantee, if you have quarantine agents in an airport, that some people like that will be picked up. But what I was saying is that to get this guy and get the proper diagnosis it took specialized services. That was one of the points.

The other point was that he was diagnosed, and then reported to public health. Right now, everything is being done to get all the contacts and everything. For TB, and for meningitis, we're really used to that. These are the two major, I would think, threats that could come back and forth. I'm not talking about a pandemic flu. That's another thing. But with TB and meningitis, there are not that many. I was the provincial epidemiologist for the province of Quebec for eight years. In those eight years, in Quebec, we may have had fewer than five or six of those cases. But when they come, we're fully trained to reach out for contacts and do the thing. There are liaison between provinces and territories in Canada and the U.S. That's what is happening right now.

[Bonnie Brown, Liberal, Oakville, ON]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Madame Gagnon.

[Christiane Gagnon, Bloc, Québec, QC]

I agree with you that we should not go beyond what the current bill provides for the surveillance of travellers. I think that individuals have some responsibility. Perhaps they do not want to disclose the fact that they are suffering from a dangerous infectious disease. In many cases, they are aware of that fact, but they do not want to declare their disease. If this cannot be determined at boarding time, then all the passengers of the aircraft would have to undergo a diagnosis even before boarding, which is impossible. It would be extremely complicated to do this for ground transportation.

Why are the United States not asking for the same kind of protection? As Canadians travel South, the United States does not seem to be worried about certain infectious diseases. As you were saying, we are not talking about ordinary diseases. When passengers move between the United States and Canada, why do the United States not feel vulnerable?

Canada feels more threatened by a potential epidemic introduced by a traveller. As you said earlier, we do have some protective measures. Moreover, individuals are expected to declare such diseases. If someone does not comply, it is his responsibility. Basically, it would be very difficult, very expensive, and I think, practically impossible to apply measures that go any farther than the current measures.

[Dr. Monique Douville-Fradet]

A bus only has one driver. He has to sit up front and drive. He does not have the time to mind the health of his passengers. A passenger would have to be in very bad shape before anyone said that someone onboard was severely ill or dying.

We would need a link or a mechanism to take care of persons who are found to be seriously ill on trains. If a passenger is found to be seriously ill, his case could be reported to the Public Health Agency of Canada, describing his symptoms, and so on. to ensure that the person is taken to a place where he can undergo diagnosis. I think that such a procedure would be good.

Nonetheless, if a passenger is seriously ill at the border, there may not be adequate facilities to perform a diagnosis. It would require physicians and other resources such as tests.

It would also depend on the type of problem. If someone comes down with a fever caused by the Ebola virus, it is obvious that he is seriously ill. He might not even get into the country alive. If he gets in, he will really be in bad shape because the disease has gone beyond the incubation stage. Rapid transportation does not leave enough time for incubation to take place during a trip.

I think that in any case, there will be have to be a diagnosis along with specialized care. There is already a system in place, because the Public Health Agency of Canada is in charge of infectious disease prevention and control for the entire country.

[Christiane Gagnon, Bloc, Québec, QC]

I have no further questions. I am inclined to support the bill as it stands. It could be improved by making two amendments, but I do not think that we should go beyond the current provisions. There are safeguards in place for air travel and overland travel. However, the responsibility lies with the travellers especially overland travellers. Practically speaking, I do not think that we have all the tools and resources that we need to detect how many individuals have come down with a given disease. As you said, this is very unlikely.

[Dr. Monique Douville-Fradet]

Precisely. I entirely agree with what Dr. Kendall said when he emphasized that for SARS, intensive surveillance was implemented in airports. It was very expensive. Even in the regions where SARS was present, the number of potential cases was very small as compared to the number of people who had some type of fever that had nothing at all to do with SARS. It is a disease whose symptoms are not very specific.

[Christiane Gagnon, Bloc, Québec, QC]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Ms. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you, and again thank you very much to both of our witnesses today.

I just have a couple of questions.

We talked a little bit about—maybe it was Ms. Brown who talked about it—the no-fly lists and the gentleman in question being placed on the American no-fly list. Are those no-fly lists shared? That's one question. Would we know that as a Canadian group?

And what established relationships do you have, Dr. Kendall, or would Canada have with the border states to address reportable diseases crossing the border? Is there a good system in place to address that? And does B.C. have similar relationships with other countries, for example, Asian countries? I would think that you probably have a fair amount of travel between Asia and certain areas of B.C.

The other question I had for anybody who can answer is this. It's my understanding that section 34 of the new Quarantine Act is currently not in force, waiting for adoption of Bill C-42. So how does that affect Canada's ability to respond to a public health threat at the border?

[The Chair, Conservative, Rob Merrifield]

Go ahead, Dr. Kendall.

[Dr. Perry Kendall]

British Columbia has good working relationships with our colleagues in public health in the contiguous states south of the border. We have regular twice-yearly public health emergency planning meetings, either in B.C. or in Washington, in Portland, Oregon, or in Idaho. We have good relationships with Alaska to the north, as well. We share databases and information between laboratories and public health physicians.

Nationally, I think you would have to address that question to Dr. David Butler-Jones or Dr. Howard Njoo. My understanding is that there are very good channels of communication between the Public Health Agency of Canada and the Centers for Disease Control in Atlanta, Georgia.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Are you able to address the no-fly lists?

[Dr. Perry Kendall]

I don't know the answer to the no-fly list. I'm sorry.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Okay.

[Dr. Monique Douville-Fradet]

I don't have an answer to the no-fly list, either. What I understand of the case in the news is that his doctor had told him not to fly. But I don't know about a no-fly list. Again, maybe Dr. Butler-Jones could answer that.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Go ahead.

[Dr. Monique Douville-Fradet]

I want to say that the relationship we have with United States is one that often goes through the Public Health Agency of Canada and then to the United States, or to France or England or Asia or wherever.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Ms. Priddy, go ahead.

[Penny Priddy, NDP, Surrey North, BC]

Thank you.

Welcome, to the witnesses. Dr. Kendall, it's nice to see you.

Dr. Kendall and I have worked together in other lives.

I have to say as I begin, Mr. Chair, that I'm a little concerned that some of the witnesses we had identified to be here today, such as bus transport, motorways, and so on, are unable to be here. This is the second meeting in a row that the witnesses I anticipated would be here are not. That is notwithstanding the skill and knowledge of the witnesses who are here today. But earlier on we had discussions about having motorways and other kinds of land conveyance providers here, and they're not here.

[The Chair, Conservative, Rob Merrifield]

For the committee, they were all asked to come, and these were the two we could get.

[Penny Priddy, NDP, Surrey North, BC]

You're not taking anything off my time, are you?

[The Chair, Conservative, Rob Merrifield]

I'll add it on to your time.