Health Committee on April 14th, 2020

[Dr. Michael Strong]

Thank you very much to the honourable member for the question. I'm very happy to do that. There are 99 projects that have been funded across this country specifically for research on COVID-19. They can be broken down into a couple of categories. The major one is really medical intervention, and the second one is with respect to the social side of the equation.

On the medical intervention side, there are four broad categories. One is vaccines. There are six studies looking at novel approaches to developing a vaccine. There are 12 projects on diagnostics. There are another nine projects on transmission dynamics, which is really meant to track the spread and immune response to it. There are 23 projects looking at therapeutics and clinical management.

On the social side—because this was a partnership across all agencies—we also have a number of projects that look at the public health response and its impact, social dynamics and communication, transmission dynamics and, as I highlighted in my earlier comments, some of the misinformation and how it is being dealt with. Canada is well recognized for its expertise in these areas of social research. Those are the broad categories. I would be happy to drill down further if you wish.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

I know that this is a global issue and I have no doubt that the Canadian research community will make a significant contributions to the efforts to stop this virus. Could you give me a quick overview of the solidarity project and the role that Canada has played in that?

[Dr. Michael Strong]

Thank you very much for that.

The solidarity research project is an international consortium of countries to do research looking at promising therapeutic agents for the COVID virus, some of the very early ones being tracked. Canada is actually an international leader in that and we were there very early on. In fact, one of our investigators is a lead investigator on helping to design it and bring it to Canada. That was part of the funding. One million dollars went towards getting that started for us. Canada is robustly involved in this. It will continue to expand, we hope, over time as promising combination therapies begin to be looked at. As a research organization, we will be looking to see how we can assist in getting Canadians involved in that as well.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

What has the Canadian Institutes of Health Research seen in terms of scientific mobilization? What's come from it so far, and what can we expect to see in the near future?

[Dr. Michael Strong]

Again, that's a very good question. Thank you for that.

It has been absolutely amazing to watch as our colleagues begin to look at how they can retool their research programs to ask questions and to be of assistance to us on everything from innovative clinical responses and trials to looking at different subpopulations. We have different approaches that have been brought forward on that.

With regard to the social components, as we begin to experience this more and more, we're seeing different questions starting to come forward with regard to the epidemiology and societal behaviour. We are seeing a brisk and really enthusiastic response from Canadian researchers, who are coming to the table to try to assist with this across multiple venues.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

I just have one final question. While science has been pretty much in the forefront of all of this, we cannot forget about those in the field and those who have suffered disruptions in their work with the closure of labs and the postponing of conferences, etc. What has the Canadian Institutes of Health Research done to address the challenge of researchers, trainees, lab staff and others in the field, now that they too are facing the challenges of COVID-19?

[Dr. Michael Strong]

Thank you very much for the question. It is a critical one for all of us as researchers.

We have been working intensively over the course of the last several weeks, even before we did the April 2 announcement, to look at what mitigating strategies would be required to assist labs through a time period, which we assume will be at minimum three months, when their labs will be shut down for that.

In terms of our first wave—we announced five different points to provide assistance to investigators—we made the announcement on April 2. We are now working intensively on a package to provide assistance much more broadly to investigators to carry them through—for their staff, for their trainees, for the research components and for the animals that we want to make sure are well cared for—and that is coming as we speak.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

Mr. Chair, how much time do I have?

[The Chair, Liberal, Ron McKinnon]

You're finished now.

[The Chair, Liberal, Ron McKinnon]

We go now to Dr. Kitchen.

Dr. Kitchen, you have five minutes.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Okay. Thank you.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Thank you, everybody, for being here today and for your presentations.

With all due respect, focusing on the positives will not answer the tough questions that we need to know and the necessary questions that Canadians need to hear. That said—

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Mr. Chair, with all due respect, we can ask those questions respectfully. That's all I ask.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Mr. Chair, we all know that public health operates under 10 essential functions. I won't go into all 10 of those, but one of them is enforcing laws and regulations that protect health and ensure safety. Another is linking people to needed personal health services and ensuring the provision of health care when otherwise unavailable.

One of the services that is not being talked about a lot is the service of testing. We do know there are two different types of testing. Nucleic acid testing tells me immediately whether I have the disease or not, whether I have the virus, and serology assays tell me whether I've been exposed to it and whether I've developed antibodies to it.

Those things were brought up by Professor Attaran and as well by Dr. Strong on the question of testing, so my first question will be for Professor Attaran.

Professor, do you see the value of the expansion in the immunity testing as well, as we see it, especially for those people who are exposed to it—workers who had fallen, workers who are wanting to get back, our nurses and our doctors who have been exposed and want to get back to work—and how quickly they can do that?

[Prof. Amir Attaran]

Dr. Kitchen, thank you. It's an excellent question. It's one that we need to think about.

At some point, although that is not now, this country will have widespread ability to test people who were infected and either developed antibodies or not to the virus. We hope that those who have antibodies are protected from it. There is a little scientific asterisk about whether that's true. I think it is very likely to be true, but there needs to be some more research done in this area, and it's being done quickly.

When we get to the point of being able to test people to ascertain whether they were previously infected, developed antibodies and therefore are likely immune—not with certainty, but likely—it would be helpful to have a scheme in place where we could “passport”, to use that word loosely, those individuals. Could we give them some sort of passport that says they are likely to be immune so that they can be placed in perhaps the most forward-facing, riskiest jobs? That's because with immunity, they're likely to be quite safe compared with those who aren't.

Now, this does get into a complex area of sharing health information and perhaps limiting, for a short emergency period of time, how we use health information in ways that we normally would never want to contemplate. I think unless we take a studied look at that question and are willing to consider using health information in these unusual ways, we'll just end up making our next year more painful and risky than it otherwise needs to be. This is a very good area for Parliament to look at in terms of temporary emergency legislation.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you for that. It's a big challenge, as we go forward, with regard to that whole aspect: Do I walk around with an immunity passport to show that I've been immunized? You know as well as I do that not everybody who's exposed to an agent necessarily develops an antibody to it. Does that now become an issue that we concern ourselves with, restricting people's freedoms?

[Prof. Amir Attaran]

You're absolutely right. I'm not saying any of this is easy, nor am I saying that an antibody test will give 100% accurate results. It will give false negatives and false positives which, depending on the context, can be problematic.

What I am saying is that use of a person's immunological status is maybe in that person's own best interest. Wouldn't you love to know? Wouldn't you love to know if you were immune right now, and you could go out into the world and take it on without fear? I think most people would like to know that, but to get to a point where they can know that, or society at large can know that about groups of people, is going to require putting some water in the wine of personal privacy and how health information has been handled.

There's a knee-jerk way of thinking that any dilution of privacy of health information is terribly bad. It needs a more studied look than that.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

I'm interested to hear, hopefully from you and Dr. Strong, on this next question.

We hear about misinformation. There are a lot of drugs out there that people are throwing out there to say that they should be used. Dr. Strong, I know you will answer from a research point of view. We don't have the research on it.

There are drugs like remdesivir, hydroxychloroquine and erythromycin. People are utilizing these drugs and we don't have the research supporting the value of their use. I'd be interested to hear from both of you, quickly, where you see that and where we need to go.

Maybe, Dr. Strong, we could start with you. Is there research being done on these in Canada?

[Dr. Michael Strong]

You're absolutely correct. The single worst thing that we can do is a bunch of small, underpowered studies that will not allow us to answer the questions you're raising.

One focus we are working on now intensively with Health Canada as well as across our partner groups is to ensure that there is an avenue by which these studies can be done, and done in a manner in which they will be truly informative to us and provide answers.

A lot of things that are being reported out in the community right now with regard to certain drug efficacies are on extremely small numbers. We are learning that somebody who is 30 years old is not the same in the disease as somebody who is 70 or 80 years old.

To be able to answer your questions, not only in the broader sense but in terms of what populations they will work at, we are working hard on that. Those things are coming forward as we speak. We will be able to answer more. It is a very strong Canadian focus.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Professor Attaran, do you have a response?

I think I have a bit more time yet, don't I, Mr. Chair?

[The Chair, Liberal, Ron McKinnon]

No, you're actually done, but we could get a quick answer from the witness.

[Prof. Amir Attaran]

Doctor, what I said during my testimony was there's just no chance of a vaccine coming this year. What there is a chance of is a drug coming out of the types of clinical trials that Dr. Strong just described. Yes, they have to be large trials. Yes, they have to be well designed.

I am reasonably optimistic that drug trials will find a drug that would either blunt the worst consequences of infection, i.e., a drug that reduces the chances of death, or a drug that, if given early, prevents the disease advancing to that point and perhaps even makes that person less infectious to others. Don't I wish they had found it by yesterday? We all do. I'm afraid it's just going to take time.

In the meantime, Dr. Strong's caution not to over-interpret small studies is a good one.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Mr. Kelloway, you have five minutes.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thanks so much, Mr. Chair.

Hello to my colleagues.

Thanks to the witnesses for coming in today. It's a very interesting discussion.

Most of my questions will be directed to ISED. First, I'd like to thank our officials from Innovation, Science and Economic Development for joining us to answer our questions on the record. We know this is an extremely busy time for your department, so we appreciate your time.

I was glad to hear our Prime Minister announce that 30,000 ventilators will be produced right here in Canada for use in our local hospitals, and that Art McDonald, a Cape Bretoner, will be leading the team of scientists working on this.

Can you tell us a bit more about the design that will be used? For example, I know that the U.K. recently cancelled its order for about 1,000 simple ventilators saying that those didn't meet the needs or it needs more complex ventilators. Will we be looking at a more complex design? Are simple ventilators useful to treat COVID-19?

[Mitch Davies]

Thank you for the question.

I will give a number of points of information. There are three consortia and companies that were announced recently that will be providing 30,000 ventilators made in Canada: StarFish Medical, Ventilators for Canadians and CAE. In addition, there is the project led by Dr. Art McDonald which you mentioned, and that will come later in the process. We're working on the manufacturing partnerships for that project right now.

The ventilators that were chosen were selected by an expert review committee involving respiratory specialists, medical professionals and front-line staff. They had to assess whether this equipment would be sufficient to be used in their work settings, would be efficacious and would provide the treatment. Also, importantly, this is regulated equipment that Health Canada had to look at to determine whether they would be able to certify the equipment, as well, for use.

In selecting these three projects, we essentially had all that worked out at the same time through an agile process, in order to ensure that we would be providing equipment that would, obviously, be used and that would meet the tests of the health system and the health professionals, which is the point I think you're raising in terms of whether the ventilators have the right configuration and complexity to provide the right support for the patients. That's something we built into the process that we designed.