Evidence of meeting #56 for Health in the 41st Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.
A recording is available from Parliament.
NDP
Matthew Kellway NDP Beaches—East York, ON
Is it the case that the health care workers should always be in tier one, from your perspective, or is the answer maybe to have more tiers rather than just tier one and tier two? To what extent do you give credibility to this epidemiology issue?
Conservative
The Chair Conservative Joy Smith
Sorry, this has gone on too long. We're going to have to go to Mr. Strahl. Thank you.
October 4th, 2012 / 12:10 p.m.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
Thank you, Madam Chair.
Perhaps I will pick up a little bit where Matthew left off there. We did hear from the public health officials, both Dr. Spika as well as...I am forgetting the name of the doctor in the Yukon who rolled out the program—about the importance of letting the epidemiology of any specific pandemic determine the priority for the vaccination. They were quite passionate about not interjecting politics into that decision, and that it had to be made based on the science. Based on that, they wanted to continue to have that flexibility going forward.
I just want to take issue with something. I heard previous questioners say they didn't think the Public Health Agency of Canada got it. I asked the question of Dr. Butler-Jones when he appeared before committee on March 13 of this year specifically about firefighters and the vaccination. I just want to read his answer to me on that. He said:
...it's one of those eternal questions. The principles that underlie the recommendations in terms of priority are those who are most likely to be seriously ill or die, so protecting life, and then protecting essential functions. Clearly police, fire, first responders, central services, etc., obviously come into the category of essential services, trying to minimize disruption in the face of an outbreak, etc.
With H1, clearly firefighters and others who were at risk of severe disease were in the first tier, but we found that with people of that age, it was not a threat to civil society. If it had been, if they were either at greater risk or there was an issue of access, then clearly they would have moved up the queue.
I know Dr. Butler-Jones became the face of Canada's response to that. He indicated that if there had been a threat in the view of the public health officials to firefighters and to society in general, clearly you would have been moved up the queue.
My question is, how do you respond to that? He seems to indicate there is flexibility in the system to allow for firefighters if the epidemiology of a pandemic is threatening specifically societal infrastructure or firefighters as first responders. He seemed to indicate there was flexibility there to deal with that. If we take that away and base it now on a political policy as opposed to the epidemiology, how do you respond to this, that it would be a dangerous position to take?
Assistant to the General President, Canadian Operations, International Association of Fire Fighters
If I heard the quote correctly, he related it to the age of firefighters. Did I hear that correctly?
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
Yes. The age and health of.... He put first priority, because there was a limited number of vaccines, on the seriously ill, chronically ill—you have the list. That was his indication, that you are a robust group of individuals in society and weren't at highest risk of becoming infected.
Assistant to the General President, Canadian Operations, International Association of Fire Fighters
Let me make it clear. I think any system, even within the tiering, allows public health officers within their community.... For instance, there was the priority tier for H1N1. I am absolutely sure that public health officers, hospitals, or whatever made determinations on who we are going to do first and who we are going to do second. That's understandable.
However, I do find it somewhat of an unusual comment, and on the surface not very scientifically based. Maybe there is a more scientific basis for it that I am missing. I would suggest to you that there is no specific criteria that define firefighters differently from other health care workers. I point to Mr. Hills there. There is no defining difference in age between paramedics and firefighters. As I pointed out, in some communities they are the same people. I am not suggesting that if there is overwhelming epidemiological evidence, scientific evidence, to suggest, for instance, that males don't get this disease—and firefighting is still predominantly a male occupation, although it is certainly changing—there could be circumstances that preclude.... I think the guideline allows flexibility for local public health officers to make the decision.
Conservative
NDP
Dany Morin NDP Chicoutimi—Le Fjord, QC
Thank you very much for your testimony and for the answers you gave to my colleagues on the Standing Committee on Health. I thank you for the work that you do.
Firefighting is in my family's history and in our blood. My father was the fire chief in a village of 500 people for some time. I am sure you can understand the realities in rural areas and what a huge responsibility this role represents. In addition, my cousin is a full-time firefighter for a city with 150,000 people.
My region was relatively untouched by the H1N1 flu pandemic, but I understand that the purpose of today's meeting is to prevent a potential pandemic, or at least minimize the effects.
My colleague Matthew Kellway had a good question earlier. I will offer the rest of my time so that you can answer his question.
Go ahead, Matthew.
NDP
Matthew Kellway NDP Beaches—East York, ON
I just wanted to get back to this epidemiology question. It's really what Mark also followed up on.
If the epidemiology suggests that the real risk is a certain group in society—it could be the very young, it could be the very elderly—and firefighters and all front-line health care workers are going to largely be exempt from those criteria, are you saying that firefighters and all front-line health care workers should always be tier 1? Or are you suggesting that there should be room for more tiering, or finer prioritization sequencing, under these guidelines?
Assistant to the General President, Canadian Operations, International Association of Fire Fighters
I'm not suggesting at this point in time that they look at more tiering. I really don't think I'm qualified to answer that. My point, very simply, is that firefighters are front-line emergency heath care workers and they should be recognized in that capacity. They shouldn't be pulled out and separated, as they were in H1N1. By default, that's where they should be.
Once it goes beyond and rolls out to the provinces or whatever, if there's overwhelming evidence to define them differently, then so be it. Let the provincial health agencies or whatever have that flexibility to make that decision. At that point, we can determine whether there's any justification.
In a nutshell, firefighters are emergency medical responders.
Assistant Director, Gatineau Fire Services, Canadian Association of Fire Chiefs
Could I just add to this question?
The H1N1 flu case is a good example of inadequate communication about the classification of groups to be vaccinated.
Firefighters are all healthy individuals.
We're all robust. Look at this guy.
Assistant Director, Gatineau Fire Services, Canadian Association of Fire Chiefs
This guy was vaccinated and I was not. That's where the communication goes haywire. That's where we need to define. H1N1 is not the issue. The issue is pandemics.
Should we do more classification? We are not specialists. Should we have not been vaccinated at all? In that case, during H1N1, he should not have been vaccinated. He's probably more in shape than I am.
That's just a clear picture of what we're living. We are not scientists. We do not know which people will be affected by the pandemic. Our specialists do.
NDP
Matthew Kellway NDP Beaches—East York, ON
Very briefly, going back to where Libby started, what's the solution to ensure that firefighters don't slip out from that front-line health group to an occupation that falls into tier two in the guidelines?
Assistant Director, Gatineau Fire Services, Canadian Association of Fire Chiefs
I clearly recognize firefighters as being in the same group as they are.
Conservative
Colin Carrie Conservative Oshawa, ON
Thank you very much, Madam Chair.
I want to get back to a point I was making a little bit earlier. My colleague brought up an issue of political decision versus epidemiological decision. The example I was thinking of was that certain pandemics and flus affect young children. What we're talking about with any plan is flexibility, and I believe the provinces and territories could decide today that you could categorize firefighters as first responders, with the guidelines we have today.
What we've heard with other and previous testimony is that every place is so different. I believe you brought up examples. You can have an EMS guy and a firefighter as the same guy in one community. Up north, a first responder is a nurse practitioner.
I'm curious why you're not.... It's important that you're here and that we're hearing your testimony here, but because of the flexibility across the country, why are you not approaching the provinces and even the municipalities? I think you made a good point, Scott, that ultimately these are guidelines. Whatever guidelines we make, the province, at the end of the day, is going to interpret them the way it wants.
If you're looking after the best interests of firefighters across the country and the individual circumstances for every professional, don't you think it would be important to have those discussions with not only provincial governments but municipal governments along the road?
Fire Fighter, Barrie Professional Fire Fighters Association
If I may use Barrie as an example, because of the way it was rolled out federally, we were completely out. We weren't given that opportunity to lobby municipally or provincially. We were out.
Conservative
Fire Fighter, Barrie Professional Fire Fighters Association
Once it's changed from the federal level, we'll have that ability to make sure we're covered municipally.
Conservative
Colin Carrie Conservative Oshawa, ON
Are they saying to you right now that we're not going to have these discussions because of federal guidelines?
Assistant to the General President, Canadian Operations, International Association of Fire Fighters
If I may, I think what we're doing is striking at the source. The source of this confusion—and I'll be perfectly blunt: I think an error was made. I think whoever put firefighters in that second tier—this is only my opinion—didn't realize we are first-line emergency health providers.
What we are trying to get at is that the definition within the pandemic plan has to recognize and incorporate firefighters within that first tier. If there's a reason down the road to remove them, whether it be epidemiology or whether that determination be done in the rollout of the guideline at the federal level or in the rollout at the provincial and municipal levels, then let that happen. But we don't want a repetition of what occurred last time. In my view, with all due respect to the doctors involved, I don't believe firefighters were removed based on some of the reasons given here. I believe there was an oversight; I believe an error was made and they didn't recognize that firefighters perform a function no different from paramedics, and they didn't understand the nature of our job.
We're here because this is the source, and we want to make sure you understand what we do for a living, the risk we are at, and why we belong side by side with other emergency medical providers.