Health Committee on April 30th, 2020

[Dr. Robert Fowler]

With respect to COVID...?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Yes.

[Dr. Robert Fowler]

Yes, so far, but not everybody is out of the hospital yet.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

That's fantastic. That's incredible. Fantastic job, Sunnybrook.

I had a question about the start-up times you talked about. I wanted to talk a bit about the use of convalescent serum. As you probably know, this is old technology. I think there were some studies, both with H1N1 and Ebola, suggesting that it might be helpful, but they weren't randomized controlled trials. There is some evidence or “studies” from China suggesting it's effective, again with no randomized controlled trials.

Now Canada has set up the Concord trial—I think Sunnybrook is part of that trial—but the newspaper article yesterday noted that they drew their first batch of convalescent serum yesterday to start this up. I would take it from that you have not yet been using convalescent serum. Why has it taken so long?

Four days ago, I read an article in the Milwaukee Journal Sentinel talking about 2,600 people in the United States having used convalescent serum and, at least anecdotally, it was showing pretty good results. Why is it taking us so long to get this trial up and running?

[Dr. Robert Fowler]

There are a couple of things. Luckily, we have had many fewer infections in the country and a bit of a delay with respect to the onset of the peak. That pushes us out a little further from the U.S. Also, people could donate plasma post-infection and it could be transfused back into potential recipients. One of the challenges in that is that, despite the potentially hundreds to thousands of different systems in the U.S. where that's been done, I would say that they've learned probably very little from the experience. They can't probably say that the treatment is better than not giving the treatment. Really, the only way to test this, to know for the next thousand patients, is to be able to compare it to the standard of care in a similar group of people.

That's what that study is trying to do, and I think that's the right approach.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I want to ask a different question. I throw it to a bunch of you. The witnesses are a very well-educated group who have all been dealing with some aspect of this problem, but we are all in this together, in that most of us have kids, parents or relatives who could potentially be affected by this. We have a foot in both camps: both working with it but also having to live a life involving the reality of COVID-19.

In light of that, both Quebec and British Columbia have announced recently their intention of reopening schools sometime in the next couple of weeks. I want to give you a quote, which I don't want to attribute to anybody, but I think it suggests what some people are saying. It was that there was no evidence that asymptomatic children can spread the disease and little evidence that children can spread the disease to adults.

I would like to hear from some of the witnesses as to whether you think it's time in the next couple of weeks to let our kids go back to school. Does anyone want to start?

I see Dr. Fowler shaking his head. Do you want to start, Dr. Fowler?

[Dr. Robert Fowler]

That is a very tough one, and I am not expert enough to really comment. I'll just say that I worry that large gatherings will invite transmission.

I might address one particular element, that asymptomatic kids can't spread to adults. I would not stand behind that comment. Kids are certainly more likely to be asymptomatic, less likely to have severe illness, but I think transmission to others is still quite possible.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Would Dr. Möröy, Dr. Gerdts, Dr. Annan or anybody else like to respond, please?

[Dr. Tarik Möröy]

Thank you for this question. I think it has been debated everywhere.

I'm not a public health expert, but you're looking at Quebec. Quebec has a very heterogenous number of infections and deaths in the regions and in Montreal, so I think it would be reasonable to think about or even to debate that you have some regions that could open up and other regions that should wait longer to open up. I think it is a fair consideration to be very careful.

The difference is so big between one of the northern parts of Quebec and the island of Montreal that the people who live in these very less infected areas could ask themselves whether they could send their kids back to school [Technical difficulty—Editor] precautions that Dr. Fowler was making—

[The Chair, Liberal, Ron McKinnon]

Dr. Möröy, your sound is not very good.

[Dr. Tarik Möröy]

That specific regional openings can be made, I think could be a consideration. On the island of Montreal, the situation is much different from the situation in the north of Quebec of very few cases. In Montreal and in the care homes in Montreal, I would say the situation is extreme. The debate I was following is regionally opening, yes, but not generally opening.

[The Chair, Liberal, Ron McKinnon]

Thank you, Dr. Powlowski. I'm going to have to put an end to it there.

We'll now go back to Dr. Kitchen.

Please, go ahead. You have five minutes.

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

Thank you, Mr. Chair.

Dr. Fowler, I just want to follow up on the line of questioning that I was leading into, and Dr. Jaczek actually brought up the one I wanted to talk about regarding other drugs.

I'm interested in knowing whether you have seen, experienced or heard of lung issues, in particular, damage to the alveoli, in high-calibre athletes. Are high-end athletes who are completely physically fit and doing high performance at any greater risk to their lung mechanism?

[Dr. Robert Fowler]

I'm not sure that I could comment that they're at higher risk, but on the notion that it is only the elderly or only those who have comorbidities who are getting ill, I would say that might be the average. However, I've certainly seen lots of younger people, and some very young people who were previously healthy, who have developed severe disease. That's not the most common presentation at all, the most common risk group, but there are definitely so-called “host factors” in ourselves that might predispose beyond the typical risk factors.

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

My concern really would be more along the lines of hemorrhagic collapse and expiring from that.

[Dr. Robert Fowler]

Yes. It's a good question.

Although we have seen clotting in the blood vessels, we've not seen clinically a lot of hemorrhage, which we can see in other conditions but has not been a prominent feature.

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

Great. Thank you very much.

Dr. Möröy, thank you for you presentation. You talked about a positive aspect, the fact that there's collaboration between researchers and scientists. That's great to see, and we're seeing that across the country.

However, one of the negatives you talked about was CIHR cancelling the spring science competition. I wonder whether you could comment on how you see that maybe affecting the basic sciences, and in particular how it might have an impact on viral research.

[Dr. Tarik Möröy]

When we heard of the cancellation of CIHR spring competition, we were very surprised and now worried, because the way it works in fundamental research is that the institutions, and also the CFI, make a lot of investment in new research. They set up the labs, they provide start-up funding for several years and there are a lot of things going on before the researcher is ready to submit his or her first request for funding. When they are ready and submitted and everything is done, and they are stopped cold like that, it creates a lot of frustration.

It's creating a lot of frustration when they're stopped after all these investments by the institutions have been done, so that's one element.

The second element is that we feel health research should not be at the expense of COVID research. The response was good and I don't want to take anything of that back, but if we are seeing the monies that are flowing into COVID-19 research being subtracted from future competitions, that would compromise what we have in health research.

[The Chair, Liberal, Ron McKinnon]

Thank you very much.

Dr. Kitchen, let me just pause your time for a moment here.

I believe Mr. Thériault has his hand up.

Did you have a problem, Mr. Thériault?

[Luc Thériault, Bloc, Montcalm, QC]

Sorry to interrupt you, Mr. Chair.

I want to ask the interpreters to make sure that their telephones aren't close to their microphones. We're having the same issue that arose during the audio tests at the start of the meeting. It's unbearable.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

Mr. Kitchen, please go ahead.

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

Dr. Annan, in a press release put out by Genome Canada following the announcement of further funding for COVID-19 research, you stated the following:

Of critical importance, CanCOGeN will establish and manage a framework for cross-Canada safe data sharing, coordination and analysis.

Data will be shared with national and international collaborators to enable additional research, including Canadian vaccine development efforts. This will ultimately help respond to the current COVID-19 emergency as well as build capacity to respond and manage future outbreaks of this virus, or other pandemics.

Are you aware of any national framework for information sharing during the outbreaks of SARS, H1N1 or Ebola?

[Dr. Rob Annan]

Thank you so much for the question.

Again, I'm going to pass to Dr. Bell, my colleague, who may be more familiar with those types of questions, especially with regard to SARS.

[Dr. Cindy Bell]

I think the model for sharing in these types of epidemics is that the available data can go into public databases that are accessible for use by public health and researchers. It has certainly been the case. There's constantly one that is available for informing the flu. Whether it was available at the time of SARS or not, I'm not sure, but it's certainly the mechanism that we are going to be using for the current work that we're doing on COVID.

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

For how long afterwards would you expect an international framework?