Health Committee on April 30th, 2020

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you for that.

As I understand it, whoever does develop a vaccine will certainly cater to their country first, I would think, before the international community would have access to that. It's unknown, but it's something to think about in the future of course, with optimism that a vaccine will be developed.

The World Health Organization has established an international expert working group on the research and development of a vaccine for COVID, and this expert working group has issued a statement. The statement highlights the importance of “efforts to strengthen the unprecedented worldwide collaboration, cooperation and sharing of data already underway. We believe these efforts will help reduce inefficiencies and duplication of effort, and we will work tenaciously to increase the likelihood that one or more safe and effective vaccines will soon be made available to all.”

Dr. Fowler, in your testimony here today, you talked about... Of course, it was brought up earlier today—

[The Chair, Liberal, Ron McKinnon]

Mr. Webber, please wrap it up.

[Len Webber, Conservative, Calgary Confederation, AB]

Okay.

You talked about the pan-Canadian and international collaboration. You were saying that there's limited collaboration, whereas the World Health Organization says otherwise. I'd like to know. Is there collaboration out there? Is it sufficient?

[Dr. Robert Fowler]

I think there's a lot of collaboration around the world these days on this topic. I think we could still do better within our country at collaborating longitudinally, yes.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you for that.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Webber.

We go now to Mr. Kelloway, for five minutes, please.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you, Mr. Chair.

Hello, colleagues. It's great to see and hear from the witnesses today.

I have two questions. The first question is for Dr. Fowler.

My understanding is that you provided clinical care to patients with SARS in 2003, and I believe that in 2014 you did the same with Ebola. I'd like to hear about how the COVID-19 pandemic compares and contrasts with those outbreaks, given your experiences. What are the key similarities and key challenges in the comparison?

[Dr. Robert Fowler]

Comparing coronaviruses, SARS-CoV and SARS-CoV-2, there are some similarities and differences. One of the differences I would say is that SARS was, in large part, an illness that we saw in hospital settings. Although it was in the community to be sure, we had outbreaks within our acute care facilities, and it was a very hospital-centric problem for the most part.

COVID has of course been through the community, and we've had very limited transmission within acute care institutions. I think we learned a heck of a lot from our experience with SARS in Canada, particularly in the Toronto area, and that, I think, is generalized across the country. Long-term care homes, however, are a very different story. Whereas it was not an issue back in 2003, one of the defining issues of this outbreak is how long-term care has been hit.

Ebola is very different, and I worked in Ebola treatment units with very few staff and a very different sort of clinical context. There are a lot of psychological similarities, and patients can get very sick, but there are a lot of differences in the clinical presentation. It's a very different kind of disease.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thanks very much.

I want to keep on with a different line of questioning with you, Dr. Fowler. You talked about the solidarity project during this session. I'm just wondering if you can go a little deeper in terms of the research with respect to the solidarity project. Are there any promising results from the treatments being used?

Basically, can you give a bit of an update on that project and elaborate on it?

[Dr. Robert Fowler]

The way this trial works is that there's a continual assessment of the outcomes of the patients who have enrolled around the world. We will have the ability to learn more quickly by participating than we ever would be able to by doing it alone in Canada.

We don't yet have any signal to say that we should stop any of our treatments because of efficacy or because of harm. We're still premature on that basis. You've seen this week that there have been a couple of announcements: one through peer-reviewed literature, and one through a press conference in the U.S. about one medication. I would say it's premature to make any judgment about that one medication.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thanks so much.

I'd like to switch my questioning to the witnesses from the University of Saskatchewan. Countries like the United States and Germany, they're exploring antibody testing for COVID-19. We hear there are pros and cons to that.

While we're working on a vaccine, I'm curious as to your thoughts, your opinion, your insight. Is antibody testing something that the federal government should consider?

[Dr. Volker Gerdts]

Are you referring to testing antibodies in people getting infected or the role of antibodies, or are you talking about antibodies as therapeutics?

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Let's go with the first two and see if we have time for the third one.

[Dr. Volker Gerdts]

Therapeutics is certainly an approach that is very promising. In fact, we're starting our study in ferrets next week to look at some prominent therapeutics there. There is great promise for therapeutics to act similarly like antivirals. I think there is real value in proceeding with that.

The antibody testing in the public is giving us really good information about the level of herd immunity out there, so testing in that sense, from a public health perspective, is very important to also prepare for or have a better estimate of what the next wave of this disease might look like.

[The Chair, Liberal, Ron McKinnon]

You have 30 seconds, Mr. Kelloway.

I think Dr. Möröy had wanted to speak to something you said earlier.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Very good. Thank you.

[Dr. Tarik Möröy]

Thank you very much, Mr. Chair.

You mentioned the SARS epidemic. If I'm not completely mistaken, this epidemic just stopped without much being done. There were hundreds of deaths, not thousands or tens of thousands.

The interesting thing that happened after the epidemic was over, from a researcher's standpoint, was that a lot of the funding to study this virus dried up. It's not that nothing was done, but many things came to an end. We, the scientists, read papers from 2007 and so on in small journals that do groundwork in basic science, indicating how many other coronaviruses are out there in pets and how many other variants have been found.

This is the danger in funding research ad hoc and then letting it dry up. I don't want to say that if the research on SARS would have gone fully funded for the years after that we would not have been in this pandemic, but I think it's very dangerous to say, okay, this pandemic stopped so we don't need to fund anything anymore. SARS has shown that this may have been a mistake, with all careful consideration.

I wanted to make this point because when we discussed this on our board and among our colleagues, this was a point that was absolutely stressed. Thank you.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Thank you so much.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Kelloway.

Mr. Thériault, we go now to you. You have two minutes and a half, please.

[Luc Thériault, Bloc, Montcalm, QC]

Dr. Fowler, you touched on the topic when you responded to a question.

Am I to understand that you prefer not to comment on the current status of clinical research on the effectiveness of the four medications chosen in the solidarity clinical trial? There has been a great deal of media coverage regarding chloroquine, hydroxychloroquine and remdesivir.

Can you talk about the progress of the research and your results, or would you prefer to stick to your earlier response?

[Dr. Robert Fowler]

I would say that we're hoping to get results that we can share as soon as possible. It's not that I don't want to give any results. It's just that we don't have an answer yet. It's going to take a little while longer to get a convincing answer for you; I'm sorry.

[Luc Thériault, Bloc, Montcalm, QC]

So how do you explain the high-profile media releases in the United States, for example, if the results aren't conclusive to date?

[Dr. Robert Fowler]

One of the things that I might like to highlight is that there are a couple of places in the world.... The U.K., probably more than any other country right now with this pre-existing network of clinical research ready to go, has been able to randomize about 8,000 patients into a trial that's similar to solidarity. I'm helping with that one and I think that will provide answers very quickly. I'm waiting, just as you are, to see what Anthony Fauci was talking about yesterday, but so far we haven't seen any real results.

[Luc Thériault, Bloc, Montcalm, QC]

Okay, thank you.

You said earlier that this type of pandemic should occur more often. I'd like you to explain why. I know that you have experience with various contagions and epidemics, so I also want to know your thoughts on this.

[Dr. Robert Fowler]

Looking back over the last not even 20 years, with the examples of SARS and pandemic influenza; another coronavirus different from SARS, different from this one, the Middle East respiratory syndrome; avian influenza that pops up time to time in China; and Ebola, all of those are happening at a frequency we never would have imagined 20 or 50 years ago. I think it's happening as we encroach upon the natural reservoirs, encroach upon animal reservoirs. Also we can spread things so much more quickly now because of travel, things that would never have come away from a rural area are now in a different part of the world within 24 hours.