Health Committee on Jan. 29th, 2020

[Luc Thériault, Bloc, Montcalm, QC]

Thank you.

Dr. Tam, just now, you said something about Canadian nationals who would like to come back to this country. The Canadian government, through Minister Champagne, announced today that steps to get those people back were beginning to be taken. As I understand it, we first have to find out how many they are, where they are, and who they are.

You are telling us that the measures being taken on the ground are sufficient. What I gathered from your answer to Mr. Powlowski is that you would not recommend quarantine. Did I understand correctly? For the people coming back to this country now, are the measures being taken on the ground in China, adequate enough to allow us to operate on a strictly voluntary basis?

[Dr. Theresa Tam]

As the president already indicated, those very specific processes are still being planned. What I do know, given my communication with the World Health Organization, is that China is not letting anyone leave Wuhan, so there's that sort of containment. Anyone who leaves—and that case is extraordinary—has active screening before being allowed to get on a plane, because they don't want to let anyone out of the city. There is actually strict screening before anyone can board a plane and leave.

The rest of the very specific processes we are undertaking are still being planned. The underlying public health principle is that we have to assess individual risk, I believe. Maybe they're not all the same. We will have to look at the details of individuals who are potentially on that plane.

What I'm talking about, of course, is the measures we have right now for any traveller coming back from the affected area, which include isolating the people who are ill with respiratory symptoms. Their contacts are monitored, so there is that sort of quarantine, if you like. Anyone who isn't sick who comes in does not get quarantined if they haven't been in contact with a case. That's the general public health protocol. We will be leaning on that as part of the guidance as we examine exactly what we're going to do with passengers on any potential flight.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We'll now go to Mr. Davies for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Thank you to the witnesses for being here on short notice.

Dr. Tam, generally, or as closely as you can tell us, among those infected with the novel coronavirus, what percentage of patients have experienced severe disease?

[Dr. Theresa Tam]

Based on data coming out of China, about 20% of cases are what they define as severe. That could mean pneumonia. We know that in terms of the number of deaths, there have been just over 130 out of over 6,000 reported cases. We currently cannot estimate the actual case vitality rate. That takes time and the other outbreaks can take weeks, or in fact months, to ascertain. I think the global response has been to treat this as potentially serious. That's where we are at, with about 20%.

[Don Davies, NDP, Vancouver Kingsway, BC]

Is 133 deaths out of 6,000 cases a high percentage of deaths in relation to the number of people who have been infected?

[Dr. Theresa Tam]

Relative to something like SARS, it is lower, but as I said, there are 20% who might have a serious illness. We don't know what the clinical cause is. That is what we are watching very carefully.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Generally, how long is the period between when a person gets infected and when they start exhibiting symptoms?

[Dr. Theresa Tam]

That is what we call the incubation period, and it seems to be a whole range, anywhere from one day to 14 days. In the majority of cases—and that number is recalibrated every single day—the general incubation period is estimated to be five to six days right now, but you will have some outliers that are particularly long. In Canada we've considered the longest incubation period, 14 days, with regard to how we pursue our public health actions.

[Don Davies, NDP, Vancouver Kingsway, BC]

I would like to drill down to understand, if I can, exactly how this evacuation of Canadians is going to work in China. I've heard there are something like 160 Canadians who have indicated they want to return. Is Canada going to do any testing of those people to ensure that they are not infected with the coronavirus before they get on the plane?

[Dr. Theresa Tam]

As I've said, the details of that are being worked out. However, the Chinese authorities will not let anyone who might be infected on the plane. The rest we will be re-assessing with the protocol—

[Don Davies, NDP, Vancouver Kingsway, BC]

Is there a definitive test for people who might be infected with the virus but are not yet symptomatic? Is that the kind of test you're going to have for people?

[Dr. Theresa Tam]

The protocol of testing those passengers, all of that, is still being worked out. In China they do have the diagnostic test. No cases and no sick people will be leaving that city.

[Don Davies, NDP, Vancouver Kingsway, BC]

You read my mind. That's what I'm trying to establish. With an incubation period as long as 14 days, how do we ensure that people who are getting on the plane together don't have the coronavirus if they are not yet symptomatic? Can we definitively ensure that is not going to happen?

[Dr. Theresa Tam]

The protocols and the processes will be put in place to ensure we don't impact the Canadian public, but should anything happen on the flight, there are measures to separate anyone who suddenly develops symptoms, for example. We'll be very meticulous on how we work through all those processes in order for us to ensure that Canadians here are protected.

[Don Davies, NDP, Vancouver Kingsway, BC]

Do you know when the plane is scheduled to arrive in China and bring back the Canadians?

[Tina Namiesniowski]

All those details are being worked out, and obviously the Government of Canada is engaging closely with the Chinese authorities in relation to working out some of those details. From the point of view of the earlier questions you were asking, I can assure all committee members that we are very conscious of the concerns that exist around the potential for individuals to return to Canada and potentially be asymptomatic and then subsequently symptomatic. All of those issues are being taken fully into account as we develop and operationalize how we would ensure that we meet our obligations, pursuant to the Quarantine Act, around preventing the introduction and spread of communicable diseases into Canada.

[Don Davies, NDP, Vancouver Kingsway, BC]

If I may, I'm also concerned about the other people on the plane.

[Tina Namiesniowski]

Of course the concern also includes not just Canadians here but the Canadians who would be returning on the plane.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have one quick question. Given that there's no specific antiviral treatment recommended for the coronavirus yet, I'm curious what treatment options are available right now to infected patients. As a follow-up, do you expect a vaccine for the coronavirus to be developed in the near term, and if so, how far away are we from a vaccine?

[Dr. Theresa Tam]

The current medical treatment is supportive care. That is what's available, as it is for many respiratory viruses that don't have a specific vaccine or treatment. In terms of medical care, if someone has pneumonia you may need to support them with oxygen. If someone is really severe you may actually need ventilation. There's also hydration and making sure someone can recover from the illness.

There is an international collaborative effort to look at what the clinical course is and what kinds of treatments might be important. The world is scanning every single antiviral we already have available to see if it has activity against this particular virus, and that is a global collaborative approach. WHO is coordinating a lot of that as well. In Canada, we are pulling together our research organizations and our academic expertise in order to contribute to that global effort. That's on the treatment, on the antiviral side.

On the vaccine, there have been a number of vaccines that have been previously developed for coronaviruses, but not this specific one. The world, again, is pulling together everyone who actually has one of these vaccines and seeing what we can do to accelerate that development. What I can say is that even with the most rapid acceleration, I don't believe we are going to see a vaccine that is ready for probably a year. We have to plan for the fact that we're going to be managing this particular virus with no specific vaccine.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

We now go to Monsieur Paul-Hus for five minutes.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you, Mr. Chair.

Once again, I am a little surprised. I am here more to talk about public safety.

Around the world, countries like the United States, Australia, and others, have been taking major steps to keep the situation under control. As I understand it, we are starting to take some steps here, but first, we have to get papers out of boxes and to reactivate protocols in order to remember how to put the Quarantine Act into effect.

Can you explain to me why everything takes so long in Canada? After all, there were recommendations in the 2003 report on SARS.

Ms. Namiesniowski, could you explain to me why things are not moving quickly?

[Tina Namiesniowski]

Mr. Chair, I just want to attempt to make it clear. Working very closely with our partners, including the Canada Border Services Agency, we are implementing the Quarantine Act across the country at every single port of entry. We're doing that now. We've been doing that for some period of time, and we'll continue to do that into the future.

We're very focused on ensuring that we're meeting our obligations pursuant to the Quarantine Act. If I left the impression that we are not doing this, that is not the case. We work quite diligently and closely together to ensure that we are protecting the health and safety of Canadians. The act very much aims to prevent the introduction and spread of communicable diseases. That is a role that's played every single day at every single port of entry.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

I understand, and I do not want to criticize your work. We are here to ask questions because the public is asking them. We do not intend to create a panic either, but we want to know whether our government is ready to react.

You say that, at ports of entry, particularly the three airports, there are now notices telling people to report to a particular location.

When a flight arrives, particularly from China, of course, why are our border services officers not making sure that tests are done directly? Do we not have the tools to measure temperature, as other countries do, or quarantine areas? As it has been explained to me, I gather that we do not have separate checking lanes in the airports. Everyone from different flights ends up in the same place to go through customs.

Could we not put in place measures that are a little more robust?