Health Committee on Nov. 25th, 2009

[Dr. David Butler-Jones]

Look at the United States, for example. They started into their second wave several weeks before us. While they had a small amount of vaccine a few weeks earlier than we did, it was really a very small amount. We've now immunized at least twice as many people as a percentage of our population as they have, within the first two or three weeks of the campaign. It's the same in other countries. They have much smaller amounts of vaccine actually in people's arms.

When we assess all of this in terms of the pattern and the evolution, how much is due to the fact that we were delayed in the second wave because of all the other things we've been doing, everything from treatment to prevention, and other things? We may never know for sure, but clearly we did not experience the same level of activity that a number of other countries did. We did the vaccine in Canada.... While there were other countries that had some small amount of vaccine earlier than we did--not very many, but a couple--we very quickly have overtaken that lead in terms of our ability to immunize the whole population.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Butler-Jones.

Now we'll go to Ms. Davidson.

Or is it Mr. Uppal?

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

Yes.

[The Chair, Conservative, Joy Smith]

Well, you're just a basket of surprises today, aren't you?

Mr. Uppal, go ahead, please.

[Tim Uppal, Conservative, Edmonton—Sherwood Park, AB]

Thank you, Madam Chair.

This past week, I had the opportunity to go to India. As we were landing at the airport in New Delhi, we were given a questionnaire. The questions were specifically about H1N1. What countries have you visited? Have you been infected? Have you been in contact with somebody who has been infected?

When we landed, there was a place where you walk by scanners. Somebody was watching these scanners. I assume they were checking temperatures. They had people in masks taking these questionnaires and asking further questions if they needed to. To me, they looked like nurses, but they were some kind of medical personnel. On our return, upon landing in Toronto there were no questionnaires and there was nothing of the sort in our airports.

What's the difference? Do we not feel we need this? Why is it that other countries are doing this?

[Dr. David Butler-Jones]

There are a couple of things about that. One is that early on in the spring we did have notices that were given to everybody. When you did come back, you would have noticed general information about the flu and how to prevent its spread, etc., in Canada early on, but now it's widespread, in all communities. Really, the border issues are meaningless.

The key issue, as it always is in terms of the quarantine service and the work with airlines and others, is that if they see severely ill people they will call the quarantine officer and there will be an assessment. For the general population, it's not like you're going to bring influenza to Canada, because we already have it.

The other point is that temperature scanners were used in SARS. They were proven to be pretty much useless. It gives a sense of doing something, but it doesn't actually accomplish anything.

It's the same with having people screened directly by individuals or questionnaires: (a) it's easy to avoid and (b) you may not be sick this instant but in three hours you're coming down with it and already have spread it.

It really is much more about the general information that we have out there for the public about what to do and what to look for. It's the information that's being shared with households and is available generally and on websites. It's about what to look for, when to worry, and when to get attention, etc. That's been clearly shown to be much more effective.

A few countries do intensive screening. That is generally not very effective. It has the potential to be effective very early on if you're not actually seeing cases in the country, but with something like influenza...and not the temperature scanning, but the other questionnaires, etc. But something like influenza very quickly spreads. Also, those in the southern hemisphere are not in their flu season now, so they will need to be getting geared up for their winter season when it comes.

Paul?

[The Chair, Conservative, Joy Smith]

Dr. Gully.

[Dr. Paul Gully]

If I could add to that, another thing we learned during SARS was that the amount of time and energy that has to be put into producing pamphlets and getting pamphlets onto airplanes, handing them out, especially in an airport such as Toronto's, where you might have 80 or 90 airlines, is huge. It's tremendous. Therefore, I think we felt, going on with what Dr. Butler-Jones said, that if that was not effective, then we should be using those resources elsewhere.

[Dr. David Butler-Jones]

As you'll remember, early on in that outbreak we did have information that was handed out to all passengers for them to know what symptoms.... But again, there were few cases in the world, and we were actually the origin of most of them.

[Tim Uppal, Conservative, Edmonton—Sherwood Park, AB]

Thank you.

[The Chair, Conservative, Joy Smith]

Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

To follow up on the public awareness advertising, how does this compare to how the country faced the SARS crisis? Compared to that episode, how much more has gone into public awareness?

[Dr. David Butler-Jones]

I don't think there really was a lot in SARS. There was, as Dr. Gully has mentioned, the production of handouts for airports, etc., but most public communications was responsive to media questions; there wasn't actually a concerted effort to do it.

At the same time, there wasn't as much that you could actually do about SARS, It was a much more localized challenge. It had an effect on the whole country, but it really was the Toronto region that was most heavily affected.

[Patrick Brown, Conservative, Barrie, ON]

Cathy spoke about the quick service in her local health unit. I noticed that in Barrie. Is this something you're noticing across the country, or are there some health units or some regions of the country where there still is concern about long lineups?

[Dr. David Butler-Jones]

Of course I don't know about all sites, because there are probably thousands of sites across the country, but generally the reports are coming back that people are very positive. They may have a wait, but it's very efficient.

Here in Ottawa, people talk about getting their vaccine as being very orderly. Even if there are 1,000 people there, at most they wait an hour to an hour and a half while going through the process. In general, they don't even have to wait very long at all. It's very positive. It's actually rather nice that some of my old health units have turned out to do a really good job. I'm not there anymore, so I can't take the credit.

[The Chair, Conservative, Joy Smith]

Thank you very much.

I know that at 5:30 sharp we're going to have the bells ring, so I want to take an opportunity to thank you once again for coming and informing us—

[Joyce Murray, Liberal, Vancouver Quadra, BC]

We still have four minutes. It's the Bloc's turn.

[The Chair, Conservative, Joy Smith]

Well—

[Joyce Murray, Liberal, Vancouver Quadra, BC]

It's not 5:30.

[The Chair, Conservative, Joy Smith]

We only have 15-minute bells. If you....

Make it very short, because I'm going to cut you off.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

That is fine, Madam Chair. All you have to do is interrupt me.

Dr. Butler-Jones, you stated that we have now reached a plateau in this crisis. Do you not feel that some could say that the worst is over, that the number of cases has peaked, and that they might wonder whether the H1N1 crisis was really such a big deal? Could they wonder whether they had been urged to get ready and to get vaccinated for nothing? As you told my colleague, it could turn out to be more or less like a normal flu. Under those circumstances, people could wonder, if the H1N1 crisis has hit its peak, why they should get vaccinated now.

[Dr. David Butler-Jones]

It is very important to get vaccinated because we still have more hill to climb before we reach the peak. It is very important to reduce the effects of this infection, because of the thousands of hospital stays, the intensive care, and, of course, because of the deaths. Prevention is possible in this case. For many infections, prevention is not easy. Without the vaccination, millions of people could be infected and have to spend three or four days in bed. Thousands of others might have to go into intensive care and hundreds might die. This is our opportunity for prevention. It is very important. The crisis is not over. Before it is over, approximately four to six million Canadians could be infected.

[The Chair, Conservative, Joy Smith]

Thank you very much, Dr. Butler-Jones.

Thank you to the committee.

The committee is adjourned.