Health Committee on April 21st, 2020

[Jocelyn Formsma]

I'll be very short.

The only thing I want to add is that we are hearing that the workers and the volunteers at the friendship centres are also experiencing great mental health strain from feeling they're not doing enough and not meeting enough of the communities' needs. We've been trying to figure out how we support the front-line workers in dealing with their mental health in addition to community members' needs.

That's all I'll add. Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Merci, Monsieur Thériault.

We go now to Ms. Ashton for two and a half minutes, please.

[Niki Ashton, NDP, Churchill—Keewatinook Aski, MB]

Thank you, Mr. Chair.

Building on what you've been saying, I was wondering, President Sheppard-Buote, if you could perhaps reiterate how insulting the lack of funding is for urban indigenous communities, as well as the imposition of a deadline on the grants that were being made available. Does this need to change now?

[Christopher Sheppard-Buote]

For what friendship centres have contributed to Canadian society and what they do every day, I want to start seeing that recognition and that trust instead of hearing about it.

We hear a lot that friendship centres do great work. They support people every day and they make millions of client contacts each year, with 3,600 employees, but we have seven days to prepare a national proposal to support our organizations on the ground when we have people chasing down commercial sanitation trucks to get enough supplies to keep their homeless shelter sanitized. Then we're told to write a proposal and to have our measurements and our data collection strategy in place. As someone who used to be an executive director of a friendship centre, I couldn't expect our organizations to do it, and I felt bad for other urban organizations that may not have had the capacity.

[Niki Ashton, NDP, Churchill—Keewatinook Aski, MB]

Thank you.

President Obed and Grand Chief Daniels, we heard about the urgent need for food security, and there was mention, Grand Chief Daniels, of the lack of access to baby formula in Little Grand Rapids. Should the federal government be stepping in to make sure that whether it's diapers, baby formula or healthy food, they are made available now to fly-in communities?

[Natan Obed]

Absolutely, and there have been announcements of a top-up to Nutrition North's expansion of specific items, but there's a larger issue of food insecurity and poverty that has to be addressed in the long term.

Also, on a day-to-day basis, we don't know where the COVID-19 response is going. We don't have a full understanding of all the effects of food insecurity on our vulnerable communities, so next month we may need something very different from what we need today. We need it to be front of mind that people are already hungry and that our response has not been enough systemically, so at this time we need even more.

[Grand Chief Jerry Daniels]

Food security needs to be addressed right away. There can't be any back-and-forth about how it's the province's jurisdiction. The federal government is responsible for indigenous peoples, period, so we need to make sure that those kinds of things are being provided for our communities and our community members.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Ashton.

That concludes our second round of questions. We will start our third round now with Mr. Jeneroux.

Mr. Jeneroux, please go ahead for five minutes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Thank you, Mr. Chair. It's good to see everybody again this week.

I'm going to split my time, if available, Mr. Chair, with MP Vidal.

The one question I want to get out there is on testing. If anyone is able to answer, that would be great. How available are tests on reserve? Where do people get the tests done? Are temporary hospitals being established in communities, or are they being considered?

Thanks.

[Valerie Gideon]

I will ask Dr. Wong to start on this question, and I may supplement if there's time.

[Dr. Tom Wong]

Thank you for the question.

Currently in our nursing stations in all first nations on reserve there are swabs, and nurses are available to take samples from the nose and send them off to the provincial laboratory system. As you know, in each province there are guidelines on the criteria for testing, and we follow the guidelines of the province where the particular reserve is located.

In addition, we acknowledge there's a lag time, both in transporting the swab to urban centres where the provincial labs are situated and also, as you have heard, in wait times, depending on the province. Some provinces have longer wait times and longer turnaround times for the results to actually get back.

One of the latest developments is the approval by the regulators here in Canada, by Health Canada, of two rapid point-of-care test kits. One is produced in the United States and the other is produced in Canada. Those two test kits have the potential of bringing the testing much closer to the community.

For the U.S. tests, unfortunately, because there is currently difficulty in getting some of the test equipment and test kits out of the United States, they are therefore slow coming into Canada. Those test kits and that equipment produced in the United States are being placed in hospital labs.

Currently the product produced here in Canada, which recently got approved, is not available other than for beta testing, for pilot testing by a provincial laboratory system and the National Microbiology Laboratory. When we asked the company, they said the reason is that they have to internally ramp up their production schedule in order to come up with the test machines as well as the test cartridges. They are hoping that in a couple of weeks' time they will be able to have some boxes of equipment and cartridges available for testing.

In the meantime, over the next week or two, all they have is a very small number of test kits and some test equipment for provincial laboratories and the national laboratory to actually validate the testing. At that point they will be able to ramp up the testing so the test kits can actually go all over Canada. However, even at that time they are expecting that in the beginning they will have only a small supply, and then the supply will increase over the course of the coming weeks and months.

[Valerie Gideon]

On the field hospital side, what we're doing now in remote and isolated communities is we have pre-positioned some mobile, temporary structures that can be deployed, flown into a community setting, which then can provide extra space for testing purposes or assessing individuals.

They're not intensive care units. The idea is that individuals would be able to be tested, assessed, and then, as needed, would be transported out of their community and brought closer to a hospital system to ensure that they're properly treated, as may be required.

[Gary Vidal, Conservative, Desnethé—Missinippi—Churchill River, SK]

Thank you. My question is for Ms. Gideon as well.

In the application process that's been much talked about today on the urban side, there's obviously been some concern expressed. Can you tell us who was at the table in making the decision on how to allocate that money and what criteria were used?

[Valerie Gideon]

We had representatives within the department with expertise in terms of social programs who led the coordination and the assessment of the proposals very quickly. Those recommendations were then brought to our deputy minister and will be brought to our minister. We expect decisions to be able to be finalized within days.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Vidal. Thank you, Mr. Jeneroux.

We go now to Mr. Van Bynen. Mr. Van Bynen, you have five minutes.

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

Thank you, Mr. Chair.

This question is for Dr. Wong and Ms. Gideon.

On April 10, there was a technical briefing with Minister Miller and you that brought out the fact that first nations and Inuit communities were susceptible to COVID-19 because of housing overcrowding, which can make it difficult for people to self-isolate. Since the briefing, have different communities found potential solutions for this issue so that individuals testing positive for COVID-19 can self-isolate safely? What roles does ISC play in this?

[Valerie Gideon]

I can speak to that. Communities have looked at various options. Some are renting hotel rooms that are nearby or in the community, and we are helping them to pay for that. Some of them have repurposed other facilities that they have in the community in order to create those spaces, and some have purchased—or we have purchased for them—ready-to-move trailers that offer individual spaces.

The World Health Organization has also issued guidelines for preparing such spaces, based on public health expertise, to ensure that they are safe and protect individuals who are within them. We are working community by community or, in some cases, with tribal councils, or assisting communities with respect to identifying what their space requirements are.

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

Thank you.

I'd heard that the department was looking into tents to be used as temporary shelters for health care provision, and I'm hoping that you can tell us if they are are still being considered as an option. If so, in what capacity will they be used? If not, what were the deciding factors on that conclusion?

[Valerie Gideon]

These are mobile structures. I think they are very self-contained, and they would be used for medical assessments, testing and stabilization of patients. We have purchased a number of them directly, and we have also worked with a first nation partner in Saskatchewan to purchase some for pre-positioning in Saskatchewan and Alberta. We're pre-positioning some in Manitoba and Ontario as well. They can be flown in and deployed as required. Those are the purposes, and we've done that. We have about 47 so far that we've secured.

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

Thank you.

My next question goes out to the community leaders. In addition to the challenges posed by the current housing conditions in the indigenous communities, what other issues relating to preventing and stopping the spread of COVID-19 within these communities have been brought to your attention? What is currently being done to address those issues?

I'll start with the Grand Chief.

[Grand Chief Jerry Daniels]

Just to reiterate, every community is doing different things. Many of our communities have just shut down their border. I think that this has been a good strategy, in that if your community is isolated, maybe the community can still be a community and still have some community events if you can keep it out that way.

That's a good thing in terms of the mental health aspect. If we can isolate it from our communities, then maybe our communities can still function in the way that we did and not be ethnically isolated from each other. There's that aspect.

The other thing that I think needs to be done is that we need to have more involvement of the health care system when it comes to communicating the who, when and where about people who are being confirmed positive. That was the biggest concern for many of our communities: If we have a community member who is sick, we would like to know. We don't need to know who it is, but we would like to know if the person is from one of our communities. That's kind of been an ongoing thing.

Thankfully, we haven't gotten to that point, but how fast the spread happens is probably what we're most concerned about. Should that occur, we would like to know immediately, so that we can respond properly. If you're not isolating quickly enough, it's not going to work. It doesn't matter how many isolation areas you have; if it's not done fast enough, it's just not going to work. That, I guess, is their biggest concern.

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

I'd like to go back to an earlier statement you made: that you'd like to rebuild the health care system. Frankly, I'm glad to see that you're making a bold statement such as that, but more importantly, it is important for me to hear that you're doing something about it. Your initiative to go down to Cuba to find other solutions is really reassuring.

We've heard of all the money that's being made available. I'm not going to recite those numbers, but I've heard that it's not enough and I understand that. I've also heard that it's just the beginning. However, what concerns me is the discussion about how the decisions are made and how the distribution of funds doesn't appear to be equitable in some cases.

Is there a more equitable, more responsive or more efficient and accountable way that you'd recommend be considered in the distribution, or the funding, of any of the programs that relate to your community?

[Grand Chief Jerry Daniels]

It's as simple as the demographics themselves. We're 4% or 5% of the population, so 4% or 5% of the allocation should be for indigenous communities.

We're the closest to the ground, to the political representatives here in the region, and we respond very effectively to our communities. We've done our best to have their buy-in. What we're seeing is that buy-in. They have bought into having a Cuban model, Cuban doctors in our communities.

Let's see what type of impact that has. If we see an increase in health outcomes as a result, because we're taking preventative action rather than providing a solution after or providing a response later, we're going to get a better return on investment. I think that's what everybody wants. Everybody wants the best use of our resources, so let's look at examples that people are saying work around the world.

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

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Van Bynen.

We will go now to Mr. Vidal.

Please go ahead. You have five minutes.