Health Committee on April 30th, 2020

[Dr. Robert Fowler]

That's a very specific question around caring for very critically ill patients. It's something that has had a bit of attention in the media. I'll say briefly and to the point that it's probably a bit of a risky practice. It's not one that health care professionals, respiratory therapists, physicians, nurses, etc. would generally endorse as a very good strategy. The specifics we could get into, but it's not a safe practice to undertake as a plan A through F, I would say.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

It's interesting. We've heard either through testimony or just through a number of other individuals about how it's either working or not working in other countries. Hearing your caution on the ground, I think is probably fair and is something this committee should certainly consider.

Mr. Chair, my time is up, so I'll cede back my five seconds. Thanks.

[The Chair, Liberal, Ron McKinnon]

I got you at 30 seconds.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

You just want to hear my voice for 30 seconds longer. It's fine. I'll give you back 30.

[The Chair, Liberal, Ron McKinnon]

Thank you.

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

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

Thank you very much, Mr. Chair.

As usual, thank you so much to all of our witnesses. The amount of expertise that we have in this room blows me away.

Dr. Gerdts, you spent an awful lot of time speaking about the work that your organization is doing. I want to thank you for that. It's incredible and it gives us hope. However, the question I'm going to ask is what I think most Canadians and what most of us in the room are wondering: Exactly how close are we to a coronavirus vaccine?

We've heard a lot from Dr. Gerdts, so I'll start with Genome Canada, then go to Dr. Möröy and then come back to VIDO-InterVac to finish it off.

How close are we to a coronavirus vaccine? Who will vaccines be tested on? How will that be determined?

[Dr. Rob Annan]

Thank you for the question.

To be totally honest, I am going to defer to the experts at VIDO-InterVac. The work we're doing will no doubt and hopefully support their very important and very good work, but we at Genome Canada are not in vaccine development in anything like the way they are. I'll just defer.

[Dr. Tarik Möröy]

I think it's very difficult to give you a number of months or years.

I'll give you two examples. HIV has been there for 35 years. We have excellent antivirals, molecules, but no vaccine. The virus is more complicated. There will be a vaccine maybe sometime, but it is difficult. Hepatitis B had a very early vaccine with an attenuated virus and then a recombinant vaccine, which has now been used for decades. Somewhere in between these two it will be.

Now the issue is testing, and Volker Gerdts is the most competent here to answer. You need to test controlled cohorts during the course of an infection, and that takes time. Even antiviral clinical trials can be faster than clinical trials for the vaccine.

There you have hepatitis B and HIV, and we're somewhere in the middle. Predictions are very hard to make.

[Dr. Volker Gerdts]

I just want to echo that I think it's very hard to exactly predict right now when this vaccine will be available. As you can imagine, we have people here who are working essentially around the clock to get this done as quickly as possible. I think what we might see, though—and this is what I want to alert the committee to—is that some of these vaccine candidates, our own or others from around the globe, might get approval under what is called an emergency authorization. Essentially, after completion of a phase II trial in humans, it may get approval from the regulators to be used in individuals who are facing a higher risk of being infected, for example. Under that scenario, I could see that under an emergency authorization, the first vaccines might become available within the next 12 months.

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

All right. Thank you very much.

I will say it's amazing that Canadian know-how is playing such a huge part incoming up with a vaccine for coronavirus.

I want to go over to Genome Canada for a quick second.

Dr. Annan, you spoke about the $40-million investment in the genomics network. What is the role that genomics plays in finding a treatment or a vaccine for this virus?

[Dr. Rob Annan]

The $40 million, broadly speaking, that is going to go to CanCOGeN is split into two pieces. There's a viral sequencing element and a human sequencing element.

On the viral sequencing element, it's really designed to do two major things. One is to use the mutations that accumulate in the virus as it's being transmitted to be able to, in effect, track its spread. It becomes a very useful tool as we start to reduce some of our social distancing to monitor how it's spreading. It also allows us, by looking at regions that are more mutated and less mutated, to perhaps home in on some candidates for these vaccines. That genomic information can be useful to the people who are actually doing the vaccine development.

On the human side, the other $20 million is really to look at the genetic variations between patients and at how those inform their reactions, because what that might do is identify specific genes that are, for instance, more common in low-symptom patients. That could help point at potential therapeutic drug interventions, and so on, that aren't necessarily a vaccine but are rather small-molecule interventions. There are a couple of different strategies in that way.

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

I guess I'll guide this last question to anyone who feels that they might have insight into this issue.

We know that Canadian companies are working very, very hard to come up with a vaccine, and we know that countries all around the world are doing the same thing. Is there a complete sharing, or is there a feeling of protectionism among these groups, these businesses that are coming forward with perhaps future vaccines for coronavirus? Are they sharing all of this information with every country that's working on this?

[Dr. Volker Gerdts]

Maybe I can take that question.

As part of these expert group meetings that the World Health Organization is organizing weekly—and we're part of that—many of the vaccine manufacturers are actually presenting their data. They're sharing their data publicly. There is willingness to share the information, the results, with each other.

We have also now seen in the news—and details are just starting to come out—that some of the larger manufacturers, including AstraZeneca, for example, that may have access to certain technologies are considering approaches to make them globally available to other countries, and maybe, under a licence, to allow manufacturing in specific countries. That is something that is currently being looked at and is currently in the process of maturing, so I can't really speak to details, but I think we're seeing that there is a global approach to this.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Fisher.

Mr. Fisher's time is up. Is there anyone else who wishes to give a quick answer?

Seeing none, we will go now to Mr. Thériault.

Mr. Thériault, please go ahead. You have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I want to thank all the witnesses for their important contributions.

I'll pick up from the last question. It was my first block of questions, by the way, this issue—

[The Chair, Liberal, Ron McKinnon]

Mr. Thériault, could you bring your mike down in front of your mouth, please? Mr. Thériault, your mike is not—

[Luc Thériault, Bloc, Montcalm, QC]

My question is for Dr. Fowler, who participated in the World Health Organization's solidarity clinical trial. Earlier, Dr. Gerdts said that the WHO set up an expert group so that we could strengthen our efforts to work together and share information. You said earlier that you had no conflict of interest in terms of research and grants.

Some people are concerned that intellectual property rights may impede access to treatments and vaccines. They're suggesting alternatives. I gathered from the response earlier that this is still ongoing. How should we manage intellectual property when it comes to the development of treatments and vaccines? In addition, could the traditional marketing contingencies affect the availability of a potential vaccine? Lastly, I want to know what you think about the possibility, which Dr. Gerdts touched on briefly earlier, of the public and private sectors working together on basic research.

[Dr. Robert Fowler]

Thank you very much. I can take the first stab at this, but I think it's likely a shared response.

I have been helping the WHO with the Solidarity trial. It's a trial that focuses on looking at medications for the treatment of patients with COVID-19 and isn't likely to engage vaccine testing. That's possible, but that's not part of the current layout of the trial. It's very much focused on treatments for patients who right now are hospitalized and sick with COVID.

I'll stop there and maybe turn it over, if you wish, to others working on the vaccine.

[Dr. Volker Gerdts]

From my perspective, while intellectual property is certainly important for the commercial manufacturers in making sure their technologies are protected, and while these expert groups with the WHO are confidential in nature, I would also say that in a situation like this, intellectual property cannot stand in the way of developing a vaccine for people who are dying on the streets.

I think that is being globally recognized by everybody who is in the business and currently is involved in trying to make a vaccine available as quickly as possible. Speaking for our own organization, it is certainly something that needs to be addressed, but we are not actually addressing it at the moment. At the moment, we're really focused on the science and getting a vaccine as quickly as possible.

[Dr. Rob Annan]

Perhaps I'll add a perspective from Genome Canada. We're not on the vaccine development side, but the network we're leading is going to be developing and generating an immense amount of data around both the virus and the number of the patients.

Everybody who is involved, from public health labs all the way through to individual researchers, is signing on to commitments to make that data publicly available and deposit that both into national efforts and also international databases that then can support worldwide efforts. It's really very much about open science in terms of the data.

[Luc Thériault, Bloc, Montcalm, QC]

I gather from your responses that you don't anticipate that marketing activities will delay the distribution of a vaccine. You don't anticipate any delays in this area. You believe that everyone will work together to make a vaccine available as quickly as possible.

Do I have time for a brief question, Mr. Chair?

[The Chair, Liberal, Ron McKinnon]

You have a minute and 15 seconds.

[Luc Thériault, Bloc, Montcalm, QC]

Perhaps we could look at this issue from another angle. There's currently no vaccine for HIV, hepatitis C or other coronaviruses because research stopped after the respective epidemics were over. We also don't yet know whether people can develop natural immunity to COVID-19 after contracting the virus.

What makes you think that it's possible to discover and distribute a vaccine for COVID-19, especially since we don't know whether we can develop natural immunity? In addition, if we can't develop immunity, could this factor affect the quick development of an effective vaccine?

[Dr. Volker Gerdts]

I think you're correct. There are a lot of questions that we simply don't know the answer to at the moment. There are a lot of scientific questions that need to be addressed, such as whether you're susceptible to reinfection or not, if pre-exposure makes you less responsive to vaccination or not, how long vaccine immunity will last, and so on. There are a lot of questions that need to be addressed. Overall, though, comparing this coronavirus to HIV, for example, the chances of getting a vaccine for this one are better than for HIV.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We go now to Mr. Davies.

Mr. Davies, please go ahead. You have six minutes.