Health Committee on April 15th, 2020

[The Chair, Liberal, Ron McKinnon]

Your time is up, Mr. Thériault.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We'll go now to Mr. Davies.

Mr. Davies, you have two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Matthews, on April 10, 2020, the Toronto Star reported that a shipment of more than 100,000 testing swabs that had recently arrived in Ontario were contaminated and unusable. That shipment was the first shipment of an order procured by the federal government with hundreds of thousands more from the contaminated batch on the way. I'm curious. How is it possible that the federal government procured hundreds of thousands of contaminated swabs? What quality control measures are put in place for a federal medical supply procurement, and if we have them in place, why did they fail in that particular case?

[Bill Matthews]

There are a couple of aspects to this. It's quite accurate in terms of the quantity that was received and deemed unusable. I'll come back to that in a moment. There is a long-term order in place with a well-known supplier, a provider of swabs. That is a key order for us in terms of ongoing fulfillment.

I did mention in my opening remarks that supply chains are strained and new players are coming on. You have factories that are ramping up. Any time factories add capacity it comes with risk. In this case, the supplier had recognized in a subsequent shipment that they had a quality issue so they recalled that, but these ones were obviously not caught in time.

Subsequent to that, we have been working with our lab to see if those swabs can be sterilized so they could actually be put back in the system for use. We are working on that angle as well. The issue around quality control depends on the piece of equipment. Swabs in this case are typically not a problem—a known supplier in this case—but it is a strained market, so for other types of goods that we procure there is an ongoing, active test on every piece that comes in to check for quality. Obviously on swabs we have changed our quality control measures, as has the supplier in this case. It put us in a bit of a scramble in the short term, but we're optimistic that they have rectified it going forward.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Ms. Eaton, Health Canada estimates that 11 million Canadians will access online mental health services. About two million Canadians are going to need one-on-one support—short-term therapy of two to four sessions per week—to get over the crisis, as has been estimated by Health Canada.

How are we ensuring that these two million Canadians, who, I would presume, have among the most acute mental health needs, are going to receive this one-on-one support?

[Margaret Eaton]

I believe that part of what the government has announced is that there will be a care provider that will be following up with those two million Canadians. They are going to be providing that short-term psychotherapy for those Canadians. I believe that is a generous estimate, but we really don't know what that impact will be. Frankly, that is short-term support. We actually believe that more Canadians are going to need something, not just something for the first four months of this planned intervention but longer. We don't know who those people will be at this point or exactly what their needs will be.

That is one of the great unknowns. How do we make sure we have the capacity to ramp up to serve all of the needs that are coming? That is why we are seeking support from the federal government to ensure that longer term needs are met.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

That wraps up the second round. We start now on the third round with Mr. Webber.

Mr. Webber, please go ahead. You have five minutes.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair.

I thank everyone for being here today. I'm going to address my two and half minutes of questioning to Margaret Eaton of the Canadian Mental Health Association.

Ms. Eaton, thank you very much. I really enjoyed your presentation today. Your mandate of mental health for all is wonderful. It would be a dream come true if we can achieve that mandate, because currently I truly believe that Canada severely lacks the capacity for mental health services, in particular in our addictions environment.

Ms. Eaton, you talked about your association and the help out there. It's far-reaching, 86 divisions and branches throughout Canada, 5,000 staff and 10,000 volunteers, reaching 330 communities. Your phones are currently ringing off the hook right now. Your demand has surged from 25 a day to 700 a day, as you mentioned.

My first question is that, of course, the 5,000 staff would be highly trained in dealing with these calls, but you mentioned 10,000 volunteers. What type of training do they have? Do they actually do the counselling in order to help someone who is perhaps at risk of suicidal tendencies? Can you talk a little more about the training of these people?

[Margaret Eaton]

Yes. The volunteers spread out across the country would have a variety of roles. Some might be people helping out in office work, but some are peer support workers. They are volunteers, oftentimes people with lived experience of mental illness, who have received training through their branch to provide support. Some of them would be in crisis response, but not necessarily suicide response. That would be a higher level of training, which some of them would have received.

The services are quite different across the country. Depending on the kinds of crisis lines and the kinds of support that are being provided, there would be various types of involvement.

There would also be paid staff answering phones as well. What a lot of CMHAs have had to do across the country to respond to this surge issue is set up extra lines and fortify the systems underneath these telephone lines to be able to actually deal with these phone calls. They were repurposing staff who would have been running programs or doing other work to get them on the phone to handle the triage level of support for people right now.

[Len Webber, Conservative, Calgary Confederation, AB]

Excellent.

Like many others, I have shared phone numbers, such as the 811 number for the Alberta Health Link here in Alberta, and also the mental health hotline. In fact, this morning I called both in order to see how long I had to wait for assistance. I am pleased to report that in Alberta I was able to access both lines and to get somebody on the line immediately. I apologized to them. I didn't want to waste their time, so I just said, “I'm sorry. I'm okay.”

Anyway, I'm just wondering how other provinces are doing. Are people throughout the country able to get access as quickly as I was? You said that there's a vast difference depending on where you are.

[Margaret Eaton]

Yes. P.E.I., for example, has had to establish some new crisis call lines. They didn't have crisis lines they could turn to, so CMHA P.E.I. is expanding its services. Woodstock has found that its calls are up 50%, so they are repurposing staff there. Moose Jaw has also opened up a new crisis line. People are either upgrading what they have or repurposing people or adding new crisis lines in order to deal with the demand.

I think there was an initial surge in the first couple of weeks. From what I understand, it has died down a little bit, but I've been struck by the discussion this afternoon about the second wave. We do know these things come in waves, in surges. We are concerned about having enough support to provide meaningful care for people beyond a brief phone call and to be able to deliver services virtually.

A lot of the programs that people are used to going to, such as group recovery programs, one-on-one counselling or drop-in centres, have all been taken away. We've had to act very quickly to try to virtualize our services, if you will. We'll need some more support to do that and meet the demand.

[Len Webber, Conservative, Calgary Confederation, AB]

Well, thank you for what you do. I assume my two and a half minutes are up. If not, I will ask this one quickly, Mr. Chair.

It's regarding other countries. They are weeks ahead of us, of course, in dealing with this pandemic. When it comes to mental health issues, are we able to learn from the experiences of these other countries, in particular in mental health?

[Margaret Eaton]

That is a wonderful question. I've been reaching out to some international colleagues and have been trying to get that information. It has been very hard to get in touch with people. I would love to come back to the committee with more of an update on what's happening around the world as people respond. Thank you for that.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Webber. By the way, it was five minutes, not two and a half.

We go now to Mr. Fisher. Mr. Fisher, you have five minutes, please.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you very much, Mr. Chair. As usual, I want to thank all of our witnesses today and all of our technical staff for being here and putting up with us for two or three hours a day.

Dr. Liu, this is a quote from your Globe and Mail story:

Our health-care workers are our best and last line of defence in a pandemic. For their sake and ours, we need to protect their physical and mental health.

I thank you for that quote. I couldn't agree more. There is no doubt that the COVID-19 pandemic is creating mental health challenges for our front-line health care workers.

I think about how health care professionals need to think about their own mental and physical health. They need to think about their patients. They need to also think about their families back home, and I think this gets lost a little bit. Many I hear about are self-isolating from their families to protect not only themselves and their patients but also their families.

Dr. Liu, what measures should we implement to better protect the well-being of our health care workers during the pandemic, and what do we perhaps do afterward?

[Dr. Joanne Liu]

In terms of how to better protect them, I think that health care workers.... We already discussed the physical protection, and I know that Mr. Matthews is working on this. I think he heard the call and the plea.

In terms of protecting them in their environment, I think we haven't given enough guidance to health care workers on what to do about their families and haven't given them assistance if they want to isolate themselves elsewhere than their homes. As I've been suggesting, something we could decide to do is offer that you can go to a hotel, if you have an intergenerational house, not to risk infecting your mother who is 75 years old. But these things are not really enacted. I think there has been some initiative in different places, but there's no real guidance about that. I think this should be offered, because this is one of the things we always did at MSF. With Ebola, which I know is different, everybody was put up in a hotel. Everybody had their room, and everybody was isolated.

The reality of why I'm insisting on this is that we don't want them to infect their families, and the other way around: We don't want them to be infected by their families. If they were to be infected by their families, even if they were to only get a cold, they would be tested. When you get tested, most of the time you're put aside for 24 to 48 hours until you get the result of your test. If you get infected, then you're out for two weeks or even more, depending on how you pull through the event.

So there's the physical protection and the mental health protection, and I don't think there's enough of what we call groupe de parole, people to vent and speak to in different hospitals. I think mental health people from hospitals should be available for their staff as well, for all the staff. l don't think this is really happening right now in many facilities. I know there's a hotline you can call, but I think people would also like to be able to share in small groups in their hospitals.

In terms of other extra protection that nobody is addressing, the fact that.... People are putting their lives on the line, and what are we ready to do if they get infected and the outcome is death? Are we ready as a country to take responsibility for people who have put their lives at risk and made the ultimate sacrifice? Right now I haven't seen much conversation on that. I know that when SARS happened in Ontario it was addressed, but I don't think there were real conversations on that, unless I am mistaken. I haven't been told of anything like this.

I think the long term is going to be important. I'm not an expert on this; I think Ms. Eaton is much more than I am. Most of the time people can pull through the acute phase, but PTSD comes two or three months after. This is my experience at MSF. What are we doing to prevent that? l think we should be much more proactive to make sure that this will not happen.

Thank you very much.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Chair, do I still have time?

[The Chair, Liberal, Ron McKinnon]

No, you're slightly over.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you, Dr. Liu.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Fisher.

We will go now to Mrs. Jansen.

Mrs. Jansen, you have five minutes, please.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Thank you.

Thank you to everybody for coming out to this meeting today.

My first question is for Dr. Eaton. I heard a really morbid story about two farmers who are currently facing bankruptcy. They were discussing how they could make their suicides look like something else so that their wives would be able to get their life insurance. Then I heard the Prime Minister announce that restrictions will not be lifted until there is a vaccine available. My heart sank, because there are many people facing such an incredibly dark moment right now. It seems as though the message that we need to wait for a vaccine might be the straw that breaks the camel's back.

Do you think this sort of messaging poses a danger to those struggling with the current restrictions, the idea that there's really no light at the end of the tunnel? I don't think they're going to phone a hotline either, as Dr. Liu mentioned.

[Margaret Eaton]

Right. It is a dark time for many people. I think that is one of the things that are most difficult: We don't know when it will end. That is one thing that really contributes to people's anxiety right now, and there can be that feeling of hopelessness. I'm so sorry to hear about the two farmers.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Do you think the government could come with more of a light-at-the-end-of-the-tunnel type of message than what we are getting right now?

[Margaret Eaton]

It's interesting. I believe there has to be a balanced response. You have to say that you don't know what the end might be, but at the same time reassure people that we will get through it, and that we will get through it together. I think that's the balance.