Health Committee on April 30th, 2020

[The Chair, Liberal, Ron McKinnon]

Pardon me, Dr. Kitchen. We're going to have to suspend for a brief moment. We're having trouble with the French interpretation. They have to reboot the PCs to resolve the issue.

The meeting is now suspended briefly.

[The Chair, Liberal, Ron McKinnon]

The meeting is now resumed.

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

Thank you, Mr. Chair. I appreciate that.

I was asked by a reporter about your puzzle, so yes, do keep us informed about that.

Very quickly then, we're hearing that we don't really know whether there was a framework or not. How long would it take for a framework to be created? Do you think it would be best to establish a national framework for data sharing?

If we'd had that in place in December, would that have changed the situation for vaccine researchers?

[Dr. Cindy Bell]

I'm not aware of, and can't answer the question about all of the data that's needed for the vaccine research development. Maybe our VIDO colleagues could address that. I would say that the PHAC and the provincial health labs have been working together for a number of years and have created frameworks in which they make the data available, not only globally but across each other, and they share it on a very rapid basis.

Some of that, obviously, is important for the vaccine development. Certainly, genomics data has a long history of being made available publicly as quickly as possible. For instance, when the SARS sequence was done at the genome sciences centre in Vancouver, it was immediately released into the public. That is the model that is also proposed for our project in which we are sequencing the viral genomes from up to 150,000 individuals infected in Canada. That will go as rapidly as possible into the public domain, and certainly will be available for use by vaccine researchers.

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

Do I have any more time, Mr. Chair?

[The Chair, Liberal, Ron McKinnon]

You have 10 seconds.

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

I will defer that to your puzzle.

[The Chair, Liberal, Ron McKinnon]

Thank you very much.

We go now to Ms. Sidhu.

Ms. Sidhu, please go ahead for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you to all the witnesses for being with us and thank you for your contributions.

My first question is for Dr. Volker Gerdts.

I recently had a discussion with Dynacare, a health care solution company, about once there is a vaccine ready to be distributed.

Dr. Robert Fowler, you can join in the answer, too.

What role do underlying health conditions and demographic factors play in the severity of COVID-19? How will this play into the effectiveness of a vaccine? Demographically, who will get the first access?

[Dr. Volker Gerdts]

There are a lot of questions that need to be addressed. Obviously, we want to make sure that the vaccine is available to the people who need it the most, but as you alluded to in your question, I think it's very important that we make sure that the clinicians are involved in this. Any underlying conditions that may affect the outcome of vaccination need to be addressed by the physician who is seeing the patients.

[Sonia Sidhu, Liberal, Brampton South, ON]

Dr. Fowler, you can answer the second part. I have seen severe impacts on individual families and the community as we battle COVID-19. I'm especially concerned about the vulnerable populations. Diabetics, you can say, is one of them.

What role do underlying health conditions and demographic factors play in the severity of COVID-19?

[Dr. Robert Fowler]

Sometimes we take more of a measured response in that kind of question, but there does seem to be some very clear signals with respect to age and comorbid conditions, the common ones being hypertension, diabetes, maybe COPD, etc. We've clearly seen that play out clinically, where the vast majority of deaths have been related to illness and older people, particularly those who have risk factors beyond themselves, because of where they live. I would think we would be looking very strongly at not just the individual patient's medical risk factors but the social conditions, and long-term care would play prominently in that.

[Sonia Sidhu, Liberal, Brampton South, ON]

Can you clarify this? When you said recovery rates are sometimes low when they go on ventilators, is that a special population or any particular demographic?

[Dr. Robert Fowler]

Like many illnesses, the more comorbid conditions you have and the worse your state of health might be before you get very sick with this, the worse you will probably fare in getting COVID.

To clarify the earlier statement, in some of the reports from China, and Wuhan specifically, where I think they were clinically very overwhelmed, the results they had with patients getting off of a ventilator were probably not going to be so generalizable to what we have seen in other health care systems that have been able to keep up with that demand, such as our own.

[Sonia Sidhu, Liberal, Brampton South, ON]

Yesterday I spoke with an exceptional local company, Medtronic, in my riding, Brampton South. This is one of many companies leading the way when it comes to global research. They simply announced that they were releasing their ventilator design to the public to speed up research and production.

I know my colleague asked that question before, but my question is for whoever can answer. What other examples of international and Canadian collaboration can you list, and how can we speed up global research corporations? I know funding is one way, but can you elaborate?

[Dr. Robert Fowler]

I think on the clinical research side—I'm a bit biased because it's a lot of what I do every day—there is, I would say, tremendous global collaboration on clinical research right now. I think people have realized that in order to get answers most quickly, we are going to need to collaborate across the world on trying to figure out what treatments work and don't work.

[Dr. Rob Annan]

Certainly I'll say from Genome Canada's perspective that the researchers as individuals are used to collaborating internationally. What we're seeing now is a more systematic approach to this and we're having a lot of international tools. For instance, there is something called the Global Alliance for Genomics and Health, which serves to have set standards and share best practices. Its secretariat is actually based here in Canada but it is operating internationally. They do a lot of coordination work to support that on-the-ground collaboration.

Then we've had a number of companies, data companies in particular but also other biotech companies, reaching out to us just to offer to help and not for their own personal intellectual property development but to offer their services. I think we're certainly seeing a motivation like we haven't seen before.

[The Chair, Liberal, Ron McKinnon]

Thank you.

[Martin Champoux, Bloc, Drummond, QC]

Thank you, Mr. Chair.

I want to thank the witnesses for being available and for sharing their knowledge. It's very informative, and I appreciate it.

My question concerns an important factor for the future, which is the immunization acquired after contracting and beating the disease. To date, approximately one million people worldwide have recovered from COVID-19, including over 21,000 people in Canada. I don't think that we have any data to date that would lead us to believe that people have contracted the disease a second time.

My question is for Dr. Möröy and Dr. Gerdts.

How long must we wait before we have a good idea of the level of immunity acquired after fighting the virus? On that note, could more concrete tests be carried out on people who have recovered to ensure a faster verification of this factor? For example, can they return to a high-risk environment or can we “test” them in a laboratory by exposing them to the virus?

[Dr. Volker Gerdts]

Some of this work is ongoing already. There is work, studies, going on with some individuals who have had an infection and recovered from the infection. What we are learning from them is how long immunity lasts, what effective mechanisms play a role in protection and how those can be built into the vaccine research we are doing.

In terms of how long one would have to wait, you essentially develop a very strong immune response after infection. Typically within a few weeks you have a good adaptive immune response and that typically lasts months and hopefully longer. That is what we don't know at the moment. Certainly it would be great to study some of this. I think ethically it will have to be specifically addressed whether you can expose these individuals to the virus or put them in a higher-risk situation, but certainly those things are very important. We can learn a lot from people who have recovered from this infection.

[Dr. Tarik Möröy]

In the research community there are ongoing efforts to build biobanks of patient samples, and to test the serum antibodies to see whether these antibodies are neutralizing antibodies; you require these. For this we have many research institutions that are building up infrastructure to test and to come to a conclusion as to when these neutralizing antibodies appear and whether they can be used. There is still upstream research to be done. I'm not certain that you can take plasma from anyone who had the disease and use it as a therapy. Some research has to go on before you can do this.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Champoux.

We go now to Mr. Davies, for two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Dr. Hodgson, in a recent article you noted that Canada's capacity to manufacture a vaccine domestically is concerning. You were quoted as saying “From a national security or emergency preparedness perspective, the manufacturing capacity we have has really started to go down”. Should the federal government take steps to expand Canada's vaccine manufacturing capacity and, if so, do you have any specific recommendations in that regard?

[Dr. Paul Hodgson]

I should qualify that. Canada has some fantastic vaccine manufacturers, but a lot of these facilities are built for specific vaccines. Basically, Sanofi Pasteur's largest investment ever was to enhance a facility in downtown Toronto, but that's for a specific vaccine. I think you've already seen the federal government do that. They awarded us $12 million to increase our vaccine manufacturing in the level 3 facility as well as NRC.

I think the side effect of this is that companies have looked at this again and are going to bring up their own capacity. For sure, there are two sites already from the government announcements, our own and NRC's, that are now going to be GMP production facilities, I'm assuming, for emergency response. That's one of the key ones for our facility.

[Don Davies, NDP, Vancouver Kingsway, BC]

Dr. Hodgson, this article was from April 25, five days ago. What were you thinking about when you were expressing your concern?