Evidence of meeting #37 for Health in the 40th Parliament, 2nd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was h1n1.
A recording is available from Parliament.
Chief Executive Officer, Canadian Public Health Association
I think the direction has been fairly clear from the Public Health Agency of Canada, and then it spreads out through the provincial authorities to the regions, and they're certainly encouraging mass immunization.
I know that at the public health level, our public health colleagues are preparing for mass immunization campaigns, which is why some other public health initiatives have been either suspended for now or scaled back.
Liberal
Joyce Murray Liberal Vancouver Quadra, BC
Thank you.
I'll have to check where that clear directive has come out, because I've heard on the ground that it hasn't, and that it would be helpful if it were to do so. I'm not sure if all your colleagues agree that it is a clear coordinated instruction from the Public Health Agency.
Conservative
President and Chief Executive Officer, Canadian Healthcare Association
I was going to add that I have myself heard that clear directive, but I think there are areas in the health system, and the public obviously, where it is not that clear. Within the health professions there has been a great deal of debate on whether or not health care providers can be mandated, frankly, to be vaccinated, and the professions have decided that, no, there's no way that can happen, it must be voluntary.
So there is still a lot of discussion on that angle of the issue.
Liberal
Joyce Murray Liberal Vancouver Quadra, BC
The big concern I have is the no funding from the federal government. I imagine cartons of vaccines sitting on delivery docks. But the step from there to a mass immunization being completed involves a lot of cost, and I believe the estimate in B.C. is somewhere between $8 and $10 per person, depending on isolated or not isolated. This means some $25 million in additional costs for B.C. alone if 70% of the people are vaccinated. The health authorities in British Columbia are already running deficits and they have to pull back to manage their budgets. The provincial government's in the same boat.
So are you aware of mass immunization programs like this in which the federal government did not contribute to the costs of delivering the mass immunization, aside from the product itself?
Liberal
Joyce Murray Liberal Vancouver Quadra, BC
I saw a bunch of heads shaking, so I thought I'd just go on from there.
Liberal
Joyce Murray Liberal Vancouver Quadra, BC
My concern is that it just won't roll out without some funds because of the deficits that the provinces and the health authorities are dealing with. Do you think having federal funding for potential cost sharing for that $25 million would make a difference in getting the result that people are actually vaccinated in this mass vaccination, sort of theoretical exercise?
Chief Executive Officer, Canadian Public Health Association
I think additional funding and support always makes a difference. As I mentioned before, we have confidence from the public health perspective in how they will rearrange and redirect their current activities to make this happen. But additional resources are always welcome to make that happen more efficiently and more ably.
Liberal
Joyce Murray Liberal Vancouver Quadra, BC
Ms. Lynkowski, you believe that the health authorities in B.C. will be able to somehow conjure up the resources of nurse time, travel, supplies, communications, flyers, and everything else in a timely way without any additional federal resources, to the tune of about $25 million?
Chief Executive Officer, Canadian Public Health Association
No, I can't really comment on every jurisdiction. I think every jurisdiction will be different. Every region's capacity at this point is very different. Every province and territory, in fact, in terms of their capacity right now is very different, so you really have to look at it within that context. Given the fact that, as we have mentioned, there isn't much surge capacity, any additional support, however that's provided, would likely help this go much more smoothly.
President and Chief Executive Officer, Canadian Healthcare Association
I don't want to speak on behalf of other groups, but I know in several sectors--for instance with the nurses' unions and the Canadian Medical Association--the cost has been identified as a serious issue. If we want to equip everyone with appropriate masks, for instance, no one knows where the money is coming from at this point.
October 19th, 2009 / 4:30 p.m.
Conservative
Colin Carrie Conservative Oshawa, ON
Thank you very much, Madam Chair.
I want to thank the witnesses for being here today. I did want to comment, though, that the federal government has taken the responsibility very seriously. I think we've already invested over $300 million in the vaccine, over $1 billion in the pandemic plan. If you compare that to the situation under SARS, I do think there's a vast improvement. There's always room for more improvement, and I do appreciate your comments stating that on the record.
I did want to tailor my comments to the front-line workers. My background is as a chiropractor. I worked in a multidisciplinary clinic, and during SARS we had all kinds of people walking in and walking out. I met with the family physicians, and they had significant concerns about, as you said, communication and different messaging.
You mentioned in your seven points that we really have to rely on the evidence-based information. I think everybody's in agreement with that. However, even sitting on this committee, which I think keeps everybody here really up to date, we see some conflicting evidence and conflicting opinions.
My colleague from the NDP pointed to the seasonal vaccine. We've heard from an unpublished paper that if you get that, you're more likely to get H1N1. We've heard of different provinces taking different protocols. Do you have any suggestions on how to get a sole source of communications? How would we go about doing that? You mentioned a guideline that is published online with accurate information. The minister stood up in the House and said we have that accurate information available, and it's evidence-based. There appear to be problems still getting it out there. I was wondering if you have some suggestions.
Conservative
The Chair Conservative Joy Smith
I know. I think there are several questions here.
Dr. Kumar, I was noticing that you were shaking your head vigorously. Perhaps you'd like to start, and then we'll go to Ms. Fralick and Then Ms. Lynkowski.
Doctor, As an Individual
I was just shaking my head on the issue of this unpublished study that suggests that getting seasonal influenza vaccine puts you at greater risk for H1N1. I just think that's.... You know, it's unpublished. It's virtually a rumour. I don't put too much stock into it, in great part because this question has been studied by many other groups who have looked at the same thing, including us, who have found no such effect. In fact, the majority of papers that are published--I would say nine out of ten papers--say that if anything, getting the seasonal vaccine is neutral. There have been one or two papers that have said it's actually protective. So I don't think I'd put too much stock in an unpublished paper at this stage.
Conservative
Colin Carrie Conservative Oshawa, ON
I agree with you, but you brought up some important points. You're saying that these papers say this and these papers say that, but I look at you as an authority in this country on the issue. The public gets these mixed messages too, so I was wondering about bringing up the point of a sole source of communication.
Here we have front-line physicians who in a normal day may see 50 patients. Let's say that when this hits, you have the entire population with a fear factor. You've mentioned the psychological issues. I'm glad that my colleague brought this up as well. Somebody who has a cold, somebody who has the sniffles, suddenly is going to be presenting at a physician's office. So where they're used to seeing 50 people, they may need to see 100. I'm talking about communication issues getting down to the front lines.
I hear that there's really good communication between the federal government and the provincial and territorial governments. I was wondering what you're doing, or if there are things that could be done, between your group and the different regions and municipalities, so that with their distinctive desires and requirements there is some good communication material for them on the front lines too.
President and Chief Executive Officer, Canadian Healthcare Association
Thank you.
First, I want to pick up on your point about evidence. I did make that comment. I also said “when it's available”, because we don't always have evidence. The key piece of this issue we're dealing with is that it's unfolding in real time. We're learning as we go. It's a combination. Evidence isn't necessarily scientifically rigorous evidence; it's best practice. It's making sure that everyone is sharing what they're discovering on a day-to-day basis, frankly.
You mentioned working in a multidisciplinary clinic and using that as your jumping-off point. One issue that I didn't highlight, but it is in our letter to you of a week or so ago, is the concern of part-time workers or multi-facility workers, whether they are nurses, physiotherapists, or physicians who are moving from one setting to the other, where there are, let's say, different policies in place.
I could go on and on, but in terms of communications, I wish I had a good answer for you. The best I can come up with right now is that we have the Public Health Agency of Canada. We have the chief public health officer. Increasingly, I've seen the support go to that office and that officer as the sole source of information. I think we could do better on ensuring that this is the best authority. Maybe it's not final, as it changes on a daily basis sometimes with some pieces of information, but that's where we go.
Yes, I think the provinces and territories are working well together, but as I mentioned earlier, I do believe there's a need to say the same thing differently: that's not right for Canadians. So it's about encouraging that buy-in to the office and officer we have in place as the sole source of information.
Bloc
Nicolas Dufour Bloc Repentigny, QC
Thank you very much, Madam Chair. I would like to thank all of the witnesses for enlightening us.
We have been studying the H1N1 flu issue for several weeks now. We have met with many witnesses and I think we have a good grasp of the issue.
One thing has always concerned me and we spoke about this today. I would like to tie it in with the comments of my colleague Mr. Carrie. It would seem that many experts and front-line workers are reluctant to get vaccinated. Yet, they have access to a great deal of information about the benefits of the vaccine.
Perhaps Mr. Kumar can help us debunk some of the myths surrounding the vaccine. While there is no miracle solution, do you know of a way to substantially increase the number of workers who get vaccinated? We understand that they cannot be forced into getting vaccinated, but is there a strategy that could be employed to increase the percentage of workers who do get vaccinated?
Conservative
Chief Executive Officer, Canadian Public Health Association
I'll just speak quickly on that.
I would agree that this is a very real challenge. Certainly, as we spoke about earlier, although the Public Health Agency can strongly encourage it, no one can be mandated to have the vaccine.
It's a big challenge, because health care workers are also individual Canadians who also read the news and who are affected just as much. Even if they have perhaps more information than those of us who are lay people, they're also affected by what's in the news. I think we have to go back to that broad communication strategy, which also has an effect on health care workers, and urge them to get vaccinated as well. My hope is that this year our rates will improve, because certainly there has been heightened awareness around H1N1 that we didn't have previously.